Blue Shield of California, one of California’s largest health insurers, is rolling out a series of experiments aimed to improve health care for patients and physicians, the company said Tuesday.
The program, called “Health Reimagined,” ranges from expanded telehealth connections in rural Butte County to building out primary care in Monterey. New “community health advocates” in Los Angeles and elsewhere will help members with nonmedical needs, like housing and food assistance.
“We came to the conclusion that we couldn’t just incrementally improve on a system that’s fundamentally dysfunctional,” said Paul Markovich, chief executive officer of Blue Shield of California.
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Even before the coronavirus pandemic began, physicians suffered from high rates of burnout and frustration with the medical system. Patients too are frequently flustered by the cost of care, difficulty getting it, and a system that doesn’t fully meet their needs. Health insurers are a frequent source of ire for both.
“Patients are not satisfied. Providers are frustrated and burning out,” Senior Vice President Peter Long said. The system costs an “inordinate” amount of money, he said, adding “when we look at that, we think that we need a solution or set of solutions that are commensurate with the magnitude of the problem.”
Blue Shield of California, a tax-paying nonprofit with 4.4 million members and $20 billion in revenue, aims to expand those local programs that succeed quickly. The initiative builds on Altais, which the insurer formed in August to reduce physicians’ administrative burdens. In April, Brown & Toland Physicians, one of the Bay Area’s largest medical groups with 2,700 doctors and 350,000 patients, joined Altais in a proposed acquisition.
“Altais was created with the express purpose of supporting physicians adopting Health Reimagined,” Markovich said.
Primary care doctors and independent practices have faced particular stress. Many have seen revenue dry up as Covid-19 forced the cancellation of in-person appointments. The challenging economics of running a primary care practice have led many doctors to join large hospital systems in recent years, a trend that some employers fear will accelerate during the pandemic.
The Pacific Business Group on Health, a group representing large California employers, has urged the federal government to expand support for primary care. “The impending collapse of independent primary care practices represents a concern of vital national interest that must be addressed swiftly to avoid profound and irreparable damage,” the group wrote in a letter to Health and Human Services Secretary Alex Azar this month.
In Monterey County, south of San Francisco, patients sometimes have to wait six to eight weeks to get an appointment with a primary care doctor, according to Michael Larsen, executive director of the Municipalities, Colleges, Schools Insurance Group, which manages health care for dozens of public agencies in the county.