Private Payers News

Blue Shield of CA Technology Partnership Improves Care Management

Through a new care management platform, care managers can access members’ health data in one location.

care management, enrollment process, health data

Source: Getty Images

By Victoria Bailey

- Blue Shield of California has partnered with a software company to improve care management services for members and streamline enrollment for employers.

Through its collaboration with Salesforce, the payer has adopted Salesforce Health Cloud, which will help expand care management services and promote high-quality care.

The two organizations have created Care Connect, built on Salesforce Health Cloud, a care management system that combines data from 13 different information sources. The system will allow Blue Shield’s care managers to have a more complete view of member health needs and more time that can be spent connecting with members.

“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,” Bill Giard, vice president of Enterprise Architecture and Health Innovation at Blue Shield of California, said in the press release. “Salesforce’s scalable, integrated technology allows us to understand our members better, bringing Blue Shield’s reimagined care experience to life.”

Care Connect displays clinical, lab, pharmacy, behavioral health, care gap, and other health data all in one place. The data source will also help nurses, social workers, and providers create real-time care plans and connect members to in-network benefits, according to the payer.

“Care Connect allows Blue Shield’s clinical care teams to better understand our members and provide holistic care support through a new, integrated source of truth,” Tracy Alvarez, vice president of Medical Care Solutions at Blue Shield of California, stated. “This game-changing technology has helped us reimagine how to provide personalized and simplified healthcare experiences for our members.”

Blue Shield plans to work with more external partners in the future to expand member access to the platform.

The partnership with Salesforce also aims to improve the enrollment experience for employers and brokers. The current enrollment process for commercial markets tends to be manual and lengthy for payers and employers. Blue Shield and Salesforce developed a single self-service digital process that reduces the processing time for benefits administration from 24 hours to five minutes, according to the press release.

The automated solution led to a 75 percent increase in digital enrollment and a 50 percent decrease in manually reviewed group enrollment, the payer said.