A recent partnership between Blue Shield of California and Salesforce has helped the health plan reduce processing time for benefits administration from 24 hours to five minutes.
First adopting Salesforce’s traditional CRM tools in 2009, Blue Shield of California began using Salesforce Health Cloud, a healthcare and life sciences-centric platform, in 2022. It then partnered even more extensively to create Care Connect, a clinical care management system built on Salesforce Health Cloud. Care Connect went live in January 2023, said Bill Giard, vice president of enterprise architecture and health innovation at Blue Shield of California, in an email to Fierce Healthcare.
It combines data from 13 disparate systems so care managers can help patients with complex needs by looking at “one complete view of members,” which includes clinical, lab, pharmacy, behavioral health, care gap and other member health data, according to a press release.
“Our goal is to improve how we engage with and care for our members across their interactions with Blue Shield of California and we now have a platform approach that allows us to create unified member experiences,” said Giard. “Salesforce’s scalable, integrated technology allows us to understand our members better, bringing Blue Shield’s reimagined care experience to life.”
“With a growing member base and increasingly complex medical cases, Blue Shield of California needs a holistic, unified view of its members to customize care plans and address health challenges across every step of its care journey,” said Amit Khanna, senior vice president and general manager, health and life sciences at Salesforce, in a statement. “We’re thrilled to help Blue Shield create a more nimble, integrated care management platform to unify member data across multiple sources and collaboratively identify goals and interventions to have better outcomes and lower costs.”
The collaboration, supported by accounting firm KPMG, allows Blue Shield of California to develop personalized experiences for members and ensure they are connected to all in-network benefits. They said the number of members served through Care Connect has doubled and expect that number to grow and include population health management tools.
End-to-end enrollment lifecycles were streamlined into a self-service digital experience for employers and brokers, according to the release. Blue Shield of California said digital enrollment increased by 75% and manually reviewed group enrollment decreased by 50%. Different products are used for employer enrollment capabilities.