FLORIDA HEALTHCARE

Healthcare in Florida: Innovation is key driver

 

bcbsfl.com

As the U.S. healthcare system undergoes sweeping changes designed to improve the health, treatment outcomes and the well-being of Americans, Florida is at the forefront of developing health programs that are quickly becoming the model for the rest of the country — innovation that requires expansion and investment.

For example, Florida Blue, our state’s largest health insurer, teamed up with one of Florida’s leading oncology practices to create the first Accountable Care Organization (ACO) that is solely focused on attending to cancer patients. Under the direction of leaders like 30-plus-year veteran oncologist Dr. Leonard Kalman, people facing difficult health challenges are receiving better care at a lower cost.

This program came to fruition through the collaboration between doctors like Dr. Kalman, Baptist Health South Florida and Florida Blue. Together, we pored through a mountain of data and found new ways to provide better treatment to these patients while lowering costs.

This innovative cancer-focused ACO is already drawing national attention in the hope of replicating it nationwide. And it is just one shining example of how the healthcare industry is coming together to help our communities achieve better health.

As Dr. Kalman said recently: “This is an era of trying to improve quality and be cost effective.”

Serving as Florida Blue’s chief executive officer, I stand behind our mission to stay on the cutting edge by developing innovative services and products that help people and communities achieve better health. Improved health through wellness and prevention and better quality outcomes is also more cost effective.

Just as the U.S. healthcare system is undergoing significant changes with the advent of the Affordable Care Act, so, too, must companies like Florida Blue. We must find ways to stay ahead of the curve and develop initiatives that address our country’s health needs and rein in runaway costs.

Collectively, this underpins our decision at Florida Blue to go beyond a traditional health insurer and become a health solutions company.

With this approach, we see healthcare as much more than simply having insurance. We believe it is critical that we commit to keeping people healthy in the first place, a major driver to keeping costs in check. To accomplish this, we must make significant investment in the areas of wellness education, preventive screenings and other lifestyle programs such as exercise classes, instruction on better eating habits and addiction cessation.

To that end, we have also built 11 retail centers that go far beyond selling insurance and have become an instant hit with our customers. We have embedded nurses who can do health-risk assessments or help people build personalized health and wellness programs. In two centers, we have also embedded primary-care physicians who are available to our customers on the spot. These centers also connect us with community programs and serve as a hub for some of their activities. And, of course, policyholders can come in to get face-to-face answers to their questions.

In order for Florida Blue to make this transformation fully successful, we have proposed reorganizing our structure. This new approach, known as a Mutual Insurance Health Company (MIHC), will help ensure that we can make those necessary investments across our entire business to support the development of additional innovative programs that go beyond the ACO for cancer patients, our retail centers and insurance.

Even with these changes, our mission and constituents will remain the same. Our new enterprise will stay not-for-profit, run by our policyholders. Our policyholders will always retain control of the organization and we as their leaders will always be dedicated to serving their needs. We are working closely with the Florida Office of Insurance Regulation to make sure it understands our plans and the reasons for this transition.

This is a time of great change — and opportunity — in the healthcare industry. Florida Blue must be positioned to meet the health needs of our customers. In the spirit of veteran practitioners like Dr. Kalman, we must continue investing and innovating to keep our communities healthy and improve their health care outcomes.

Patrick Geraghty is CEO of Florida Blue.

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