BCBSA chief innovation officer on transforming healthcare one step at a time

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Maureen Sullivan is the senior vice president and chief strategy and innovation officer at Blue Cross Blue Shield Association. She spoke to Becker's about the organization's national health equity strategy and its goal to reduce racial disparities in maternal health by 50 percent over the next five years.

Editor's note: This interview has been lightly edited for length and clarity.

Question: What do you think are the biggest challenges the industry is currently facing?

Maureen Sullivan: I would say there are two that we are focused on and one, which was exacerbated by the pandemic, is the racial disparities in healthcare. And we came together. The board came together last November with the national health equity strategy. We announced our first effort on maternal health, which is to reduce racial disparities by 50 percent. And we're going on from there — behavioral health, diabetes, cardiac — over the next few years. I think the challenge of how we ensure access to care that has the same quality that all of our members have and all the industries should be able to access is one of the major challenges for those of us in healthcare. And I think that's a challenge that's shared by all stakeholders, each with a different perspective depending on what their focus is. But all are equally concerned about what happened in the pandemic and the disproportionate impact on the hardest-hit Black and brown communities.

We have to rethink healthcare and certain models in terms of delivery, in terms of training and education, just across the board, really rethink how we approach our care models to address those disparities. 

The second is the transformation of care. And I say that in a broad way to cover several different areas where I believe there needs to be major changes. One of the areas is integration of physical and behavioral health. During the pandemic, we saw the incredible impact on individuals' mental health and the consistent stress that the pandemic created. And so the societal impact of that has yet to fully unfold, and our ability to better integrate physical and behavioral health as an industry is a key priority.

A second is developing our understanding of how we integrate in-person virtual and home care to meet the needs of our members when they need to access care, wherever they are. I think that is a challenge that we, as an industry, need to take on and really leverage the learnings that came from the pandemic as one that can build a more sustainable model, which hopefully will also lead to greater, better outcomes and more cost-effective delivery of care.

Q: What two aspects of the industry do you think need to change?

MS: Well we are strong proponents of transparency and believe that when we look at our pharmacy spend, there needs to be more transparency from manufacturer to the script that's delivered or picked up at the pharmacy. And I think there have been more efforts on transparency with our provider partners. And I think we need to do more with pharmacy, especially given the rapid increase in costs, and the pipeline that's to come, is going to make it very difficult to afford for many members. And we need to take that on. And I think that's a nice transition to the second aspect of what needs to change; we have to look hard at what we do and how we do it as a system, and by system I mean the ecosystem of healthcare, to make healthcare more affordable. And that's a major drive that we have in looking at each of our markets for ways to align incentives, and ways to embrace new models of care that would help enhance affordability for our members.

Q: Looking back on the pandemic, are there any suggestions you would make in regard to how your industry handled it? 

MS: When we look back at the pandemic, the part that we're really proud of is the Blue plans invested $11.5 billion in the waivers for COVID testing and the kinds of services that were delivered. Even last month, there were over 150 vaccination events. There was a lot we were able to do locally to be mobilized, to support our local government efforts and federal efforts. I think the part that has yet to be fixed is the weak public health infrastructure that we have in this country. The ability to mobilize in a more consistent way when we're faced with a crisis like we were experiencing is something that I think we, as leaders at Blue Cross Blue Shield, want to join with other healthcare leaders to forge a stronger public health infrastructure to anticipate and manage any pandemics in the future with greater ease and better success. And there's a lot of loss that happened and a lot of dislocation that we think could be addressed better if we can learn from what happened. 

Q: What do you think has been your biggest accomplishment as CIO in the last year?

MS: Well, it extends a little bit beyond a year, but I would point to the development of CivicaScript. Civica was this terrific business model that was created from this set of hospital systems, and the effort was chaired by Dan Liljenquist at Intermountain Healthcare. [It answers the question of] is there a way that we can simulate bringing generics to market in a transparent way without the added costs involved, making them more affordable, particularly for generics, which there weren't any competitive alternatives for. It's one of the initiatives I'm most proud of. And the reason is it's solving a problem for our members in a collaborative way. This is an industry initiative that's joined by other stakeholders in the industry. It's not just Blue Cross Blue Shield, and it's actually piggybacking off of an initiative by a set of hospital systems. And I think it's terrific to be able to take the collaboration further. And I think it shows a lot of promise in terms of what we might be able to do. 

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