posted by AHIP
on October 19, 2020
Meet Charlene Maher, who began her career as a registered nurse and now serves as president and CEO of Blue Cross of Idaho. Formed in 1945, Blue Cross of Idaho is the state’s oldest health insurance provider. Maher spoke with us about how her organization is supporting Idahoans and promoting good health and access to quality health care.
“I am exceptionally proud of the work Blue Cross of Idaho is doing,” Maher said. “We can make positive impacts on the world of health care in ways many would not expect from a plan in a small state.”
Charlene Maher: COVID-19 has been a challenge for everyone, but we remain focused on our core mission of supporting the members we serve across the country and advocating for the health of all Idahoans. We have been working closely with our state leaders and I was honored to be asked to be part of Gov. Brad Little’s advisory committee looking at economic recovery. Forming these partnerships has been key to giving us the insight needed to take action.
We quickly expanded access to telehealth care and made it easier for our members to get the prescription drugs they needed. In addition to covering the costs of COVID-19 diagnostic testing and treatment with no cost sharing for members, we are working with our employer clients who are facing economic hardships to give them grace periods for premium payments.
We have also increased communications with our members, clients and the public to help make sure they have easy access to the answers they need.
We know that the pandemic has hit our provider partners as well, so we started an advance payment program for independent providers across our state, allowing them to get advance payments based on historical service levels to help keep their practices open after their patient visits dropped because many were delaying care.
Maher: My approach is influenced by a different perspective than most people in health insurance. I started my career as a nurse and have worked in just about every aspect of the health care industry, so I see our business with a broad view about the impact we can have. I think that allows me to look at issues we face with a human-centered approach.
Having worked in health care across the country, I know that while there are many issues we face at a national level, there are also regional concerns that are specific to a place and its population. I think having that varied experience helps me build a better understanding of what solutions will work in that place, so we can drive real change and deliver the value our members deserve.
Blue Cross of Idaho is in a relatively unique position of being able to lead on a national level while staying committed to serving our members on a local level.
We have been able to create innovative solutions and test them in a way many plans would not be able to, given our scale and relationships in the market.
We are leading the nation with our work in value-based contracts and in finding new and actionable ways to use data to help lower the overall cost of care. This kind of work can lay the groundwork for solutions that can address problems at a national level while our clients, members and provider partners can benefit from it now.
Maher: Addressing the issue by improving access to quality, affordable health care in rural communities has always been a major focus for Blue Cross of Idaho. In a heavily rural state like ours, where approximately 88% of land is considered rural and is home to 28% of the population, the issue takes on a greater importance.
That is why our charitable branch – the Blue Cross of Idaho Foundation for Health – is focused on rural health across Idaho. We are working with community leaders to find solutions that work for the needs of that community. By engaging key stakeholders, we can help drive real, lasting change. As we build on this initiative, we will work in partnership with the communities we serve, helping them facilitate change and providing expertise and resources along the way.
The Foundation is working to improve access to behavioral health services in schools with the goal of having a positive impact on children’s overall health as they grow into adulthood. We have worked with 15 schools across the state to bring private counselors into the schools to make it easier for students in need to access behavioral health services. The COVID-19 pandemic has caused some challenges, but we are working hard to adapt the program so it can continue serving as many students as possible.
Another major focus is improving access to quality, affordable health care in rural areas of the state. Idaho ranks 49th in the country for the number of doctors per capita, and we are dedicated to improving that.
Over the past 3 years, we have donated more than $5 million to rural Idaho communities, but the impact of our work goes far beyond a dollar amount.
The key to improving access for rural residents is to offer incentives and support for health care providers serving rural areas. We have partnered with the University of Idaho’s Project Echo (Extension for Community Healthcare Outcomes). This program expands access to specialty and high-quality primary care for Idahoans in rural and underserved areas by connecting local providers with specialist teams for continuing education and mentoring.
Maher: At Blue Cross of Idaho, we are focused on making sure there are more options for quality, affordable health care.
We introduced a $0 copayment benefit for children’s doctor’s office visits and some routine screening and vaccinations. I am passionate about making sure children can get the care they need. No child should ever be prevented from seeing a primary care provider because his or her parents are worried about being able to pay the copayment. Making sure that parents do not have to worry about the financial impact of basic visits is an important first step.
We are driving value-based contracts. By the end of 2019, 90% of our in-network providers were part of these value-based arrangements, the cost-savings from which allowed us to improve quality while driving down cost.
Blue Cross of Idaho is addressing affordability by partnering with providers not only through value-based contracts, but by giving them the data and analysis they can use to make meaningful changes in how they work with their patients to improve the quality and efficiency of care delivery.
Our Healthcare Economics Department has innovated with artificial intelligence to use data to reevaluate typical payor process, find real solutions to drive high-quality and affordable health care, and proactively engage our members. We are leveraging that information to deliver more relevant products to the marketplace, better support for our members through the health care journey, and partner with providers to ensure our members receive the best care at the most affordable price.
Pre-pandemic, our customer feedback and our investments were targeted heavily on affordability and while we remain focused on controlling costs, COVID has accelerated additional market needs and investments in experience and digital technology. It is imperative that health care be affordable and easy to use, which is why we have enhanced the velocity of our Digital First investment that is focused on removing abrasion in access to information and services, and improving the speed at which our members can make informed choices.
This interview has been condensed and edited for clarity.