Customer Journey BlueCross BlueShield of Tennessee
BCBST PRESENTERS ASHLEIGH JENKINS RN, BSN, LSSBB Director, Clinical & Communication Services Ashleigh has over 14 years of experience in both the insurance and healthcare industry. A registered nurse, by trade, Ashleigh has tremendous experience and insight as it relates to the clinical impact of healthcare activities. She currently leads the areas responsible for both Clinical System configuration, supporting the Utilization and Care Management activities for over 4 million member lives; as well as Enterprise Communication Configuration related to provider and member communications.. MANDY HETRICK Team Lead, Forms Transformation Mandy has over 16 years of experience within the health insurance industry. Throughout her career at Blue Cross Blue Shield of Tennessee, she has served in the capacity of the Inter Plan Liaison and Inter Plan Supervisor, handling communication efforts with partner Blue Plans . Mandy currently serves as the Team Lead over the Forms Transformation area and aids in the efforts to transform customer communication delivery at an Enterprise level. 2
Fast facts about BlueCross BlueShield of Tennessee • Not-for-profit company established more than 70 years ago • Serving 3.4 million members and 11,000 companies • Paying 85 million claims per year • Partnering with 20,000+ health care providers • Giving $14 million each year in charitable investments • Employing 5,800 professionals to fulfill this mission: Peace of Mind through Better Health 3
Peace of Mind through Better Health Our strengths Large and Small group Medicare Advantage products accounts as well as individual offer Peace of Mind to members book of business over 65 COMMERCIAL- MEDICARE GROUPS AND ASO SUPPLEMENT ACCOUNTS MEDICAID/LTSS SHARED HEALTH In the state Medicaid business Support for Shared Health, for over 20 years, successfully wholly owned subsidiary managing both full risk and handling multi-state Medicaid ASO accounts for Medicaid, business models DIDD, and Long Term Support Service members (LTSS)
PROBLEM What were we looking for? In 2014 our company began searching for an enterprise forms management system that would allow flexibility and the ability to streamline our current document creation processes. There were several driving factors that were influencing our search: Current Letter System utilized on the Claims Payment system was out of support • Letter System utilized on the Care Management system did not provide the long • term functionality that we knew we would need moving forward and to be more competitive in the Healthcare space Inability to contain cost through document standardization • Inability to automate multiple approval workflows driven by multi-business • support 5 Inability to track all of our member and provider communications in one system •
CCM VENDOR SELECTION CONSIDERATIONS Opportunities for Advancement & Innovation Industry Workflow Decrease in Configuration Leader Logic Overall templates TN Partner Available Medium Audit Trail (Print, Web, Text) Future Growth 6
WHY GMC? Approval Industry Shared Workflow Leader Content Standardization Partner Omni-Channel Tracking Enterprise Growth 7
GMC INITIAL IMPLEMENTATION MILESTONES FEBRUARY NOVEMBER 2015 AUGUST 2017 Vendor Selection 2017 Phase I Completion- Phase II Completion- Integration with Integration with JANUARY 2016 claims payment MARCH Clinical Care system complete, Project Kickoff Management System 2017 Retirement of legacy Complete, letter system Retirement of legacy Phase II Kickoff denial letter system 8
Implementation Considerations Data Model Master Template Layout Multiple Multi Line of Approval Business Support Pathways
Rationalization Review of every document to identify commonality and establish consistency in brand as well as language 10
Development Establishing data models and building documents 11
Transformation Standardization across documents means cost containment for printing/mailing letters, as well as Brand Compliance 12
GMC INITIAL IMPLEMENTATION MILESTONES FEBRUARY NOVEMBER 2015 JULY 2017 2017 Vendor Selection Phase II Completion- Integration with Phase I Completion- Clinical Care Integration with MARCH Management System JANUARY 2016 claims payment Complete, system complete, 2017 Project Kickoff Retirement of legacy Retirement of legacy denial letter system Phase II letter system Kickoff/Partnership with Brand Voice Initiative 13
Transformation 14
Results • Cost savings related to standard envelopes, removing the need to order over 50 custom envelopes • Reported 3 FTE savings in one unit switching letters to GMC Inspire off of another letter platform • Enterprise visibility into member and provider communications, allowing all of the different member/provider touchpoints to be aligned when speaking to customers 15
GMC FUTURE PLANS Other Initiatives- SEPTEMBER - Over 40 applications in the backlog 2017 to migrate to GMC Inspire Project Kickoff- - Healthy Pregnancy Program Contact Preference - EOB Transformation Integration MARCH 2018 - Member Welcome Kits - Federal Business Migration from Full Implementation of Clinical Mainframe Platform- - Integration with Appeals, Member Migration of 1500+ templates to Outreach Systems Inspire Suite - Migrate Campaigns to Designer 16
GOVERNANCE STRUCTURE Our strategy Prioritize initiatives to ensure Corporate Priorities are set Evaluate resources Combined focus with restructuring documents with Customer Experience in mind Enterprise “Top Ten” Initiative for both 2017 & 2018 17
FUTURE PLANS Leverage the full system capabilities to expand beyond transactional • documents – Incorporate document configuration in omni-channel – Leverage contract preferences – Evaluate ability to replace other content design tools Phased approach to transition additional external communications • to the GMC Inspire platform 18
QUESTIONS ANSWERS 19
BLUECROSS BLUESHIELD OF TN Contact Information Ashleigh Jenkins Director, Clinical & Communication Services ashleigh_jenkins@bcbst.com Mandy Hetrick Team Lead, Forms Transformation Mandy_Hetrick@bcbst.com BlueCross BlueShield of TN 1 Cameron Hill Circle Chattanooga, TN 37402 20
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