The BCBS Institute is celebrating its first birthday.
Created in 2018 as a subsidiary of the Blue Cross Blue Shield (BCBS) Association, the institute was formed to foster disruptive business alliances within communities to help address social determinants of health. In other words, the Institute addresses the social and environmental conditions that affect 60% of health outcomes in the U.S.
To reach this goal, the institute is breaking down the barriers at a zip code level for issues such as food and nutrition deserts, fitness accessibility, and transportation to critical medical appointments. It's a first-of-its-kind benefit corporation established to address the social determinants through technology and strategic collaborations.
Trent Haywood, M.D., president of the BCBS Institute and senior vice president and chief medical officer for BCBS, spoke with FierceHealthcare about the early progress of the program and the demands of the future to mark its first anniversary.
The institute extends the traditional healthcare delivery model into the community in order to improve that community’s capacity for healthier outcomes, Haywood said.
“The goal and vision of the BCBS board at the outset was to create—using a benefit corporation—an entity with a social mission to focus on determinants of health that allows for scalability for business practices,” Haywood said.
Although data and pilot efforts for community health programs have been tried in the past, most were not made to be sustained over a long period of time or scaled without additional investments. And the BCBS Institute wanted to do just that—take the program outside the four walls of the provider and into a community setting, for the long haul.
One year in, the mission is just as strong and in fact, Haywood says the Institute has doubled down because “that is the right thing to do.”
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So, what does Haywood do when approached a social determinants naysayer? He gives the example that when you want to manage an epidemic, you call a plumber, not a doctor. Physicians don’t prevent epidemics, they just give the antibiotics and treatment after everyone is sick.
Plus, he notes that today’s patient is also a consumer: they decide what healthcare they want, when and where.
Beyond buy-in, technology plays a large role in successfully implementing these programs. Haywood says technology allows for programs to be more affordable and scalable, plus it allows for capturing important data.
“Technology makes it more consumer oriented and easier to take advantage of services,” he added.
Like other insurance companies and payers, Haywood believes the future of the industry could be greatly affected by upcoming elections and decisions in the federal government. He’s most concerned about "Medicare for all" plans that could eliminate private insurance and make healthcare public.
“Control by the federal government would decrease innovation,” he said. Plus, there are still benefits that CMS is not able to give its members that private insurers can cover, he said.
Instead, Haywood says the BCBS Institute will continue to grow its preventative programs within the communities that need it most and address the issues facing lower-income populations.
“The general population doesn’t understand we make these types of investments with a goal of benefiting the entire community,” Haywood said.
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Haywood gives as an example the program recently introduced by the insitute, in partnership with Health Care Service Corporation, to delivery nutritious meals to deserts in the Chicago area. The foodQ program was not limited to individuals with BCBS insurance but opened up to anyone living within the designated ZIP codes.
“To help an individual we have to go after the support system,” he said.
Over the past year, other projects have included the BCBS Institute’s collaboration with Lyft to dispatch rides for patients via Lyft’s network of drivers, and working with CVS Health and Walgreens to make sure patients in rural parts of the country receive access to their medications.
Haywood said he is also surprised by people in the communities taking on very personal interpretations when using the services offered by BCBS Institute partnerships.
For example, some busy families are using the foodQ program to get nutritious lunches for their kids to take to school. When the program was originally created, that was not its intention, but now there is an added benefit. And this is once again an example of the innovation and customer convenience fostered by private programs in the healthcare system.
Looking forward, the BCBS Institute hopes to tackle fitness deserts and mental health initiatives in 2019.
“Part of what we’re going to look at is social isolation and how do you stay engaged. That might be through the creation of a fitness class to form community social groups,” he said.
There is no doubt that the BCBS Institute will play a large part in convincing people that healthcare should bust out of its traditional roles. Haywood said he and his team will continue to create and show value in giving people the opportunity to live a healthy lifestyle. At this point, it’s not just about paying hospitals for procedures, but investing money, technology and collaboration into the community for prevention, he said.
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Haywood notes that in order to do this, the healthcare systems need to look past short-term goals and be willing to invest in communities for multiple years before seeing long-term results.
“We want communities to know that we’re here to make a different and are in it for the long haul,” he said.
In fact, Haywood says that from his perspective, the social determinants of health are as important as value-based payment in reforming the healthcare system.
These “Affordability Cures,” as HCSC refers to them, are the company’s commitment to long-term solutions that address the root of expensive healthcare services by investing in social prevention programs.