BCBS of Arizona CEO: Work between payers, hospitals must strengthen

It's time for the government, payers and hospitals to work together on the future of healthcare during the pandemic and onward, according to Pam Kehaly, president and CEO of Blue Cross Blue Shield of Arizona.

Ms. Kehaly became president and CEO of Blue Cross Blue Shield of Arizona in November 2017. She joined BCBSAZ from Anthem, where she served as president of the west region and oversaw affiliated Blue Cross Blue Shield plans in eight states, as well as Anthem's speciality business. She spent 25 years working at Anthem. 

Ms. Kehaly spoke with Becker's about how the pandemic has changed the role of the health insurer, what trends health insurance executives should be watching in coming months, and lessons from the past six months that she'll keep referencing.

Editor's note: Answers have been lightly edited for brevity and clarity.

Question: Where is there more room for payer-provider collaboration? What will it take to align incentives?

Pam Kehaly: Movement from fee for service to value is difficult and has many complexities. Challenges with the current provider reimbursement structure were highlighted by the pandemic. As volume dropped, provider cash flow sputtered. If we had already been in true value-based arrangements, provider payments could have been maintained as volumes were interrupted.

Through the pandemic, providers and payers have a front-row seat to both the strength and frailty of humanity. Within that experience, I believe we are aligned in our purpose to improve health. The pandemic provides a defining moment to improve.

Q: How has the pandemic changed the role of the health insurer?

PK: The role of a health insurer is to provide health and financial health security. This is done by providing relevant information and access to affordable and convenient healthcare. The pandemic has reinforced that role, and has highlighted areas needing more focus. Convenient healthcare, for example, is an area that the pandemic exposed as an opportunity for health insurers. It became not only inconvenient, but also unsafe to go to face-to-face office visits, elevating the need for access to telehealth. Additionally, there was mass confusion about COVID-19 testing — who needs it, where to go to get a test, the kind of test that is needed, etc., highlighting the need for a reliable and consistent source for relevant information that insurers were able to fill.

Q: What trends should health insurer execs be watching right now? 

PK: Virtual delivery, digital connectivity, real-time communications, AI and automation — all fueled by sophisticated data systems. We need to catch up with expectations of how business is done today. Viewing data as an asset can help improve costs, customer experience and overall health.

Q: What lesson from the past six months will you keep in your executive playbook?

PK: Stay agile and be nimble. I would not have imagined that we could set up our workforce of 2,500 people remotely within 10 days, that our customer Net Promoter Scores would go up, and that our employee engagement scores would rise.

Communicate continuously. We increased our communication by 10 times compared to pre-COVID.

And stay human. Life is short and we need to do everything we can to take care of one another.

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