Blue Shield of California is expanding its virtual care services, citing a 7 to 10% lower overall cost of care and an average annual employer savings of $468 per member. The company’s Virtual Blue program has also led to a reduction in emergency room visits of more than 10%. According to Shah, who previously worked at Providence and founded a virtual behavioral health company called Trusana, the goal is to make virtual care a core feature of multiple plans, rather than just one plan.
The idea for Virtual Blue came from Shah’s experience at Trusana, where he saw the potential for virtual care to improve access and affordability. He notes that technology can ease the experience for both members and providers, and that virtual care can serve as a connection between different aspects of healthcare, such as primary care, specialist care, and behavioral health.
Shah points to data showing that Virtual Blue has driven down costs and improved access to care. The average primary care wait time is one day or less, compared to many days for in-person care, and specialist wait times are less than three days, compared to 15 to 20 days. These numbers confirm the potential of virtual care to improve healthcare outcomes.
The company is also working to integrate virtual care with other services, such as appointment booking and prescription price checking. Shah notes that the goal is to provide members with a seamless experience and the information and tools they need to make informed decisions about their care.
Streamlining Healthcare Services
One example of this is the company’s integration with Zocdoc, which allows members to book appointments with providers directly through the Blue Shield website. Shah notes that this has been a successful partnership, with over 2 million appointment hours booked in the past 90 days and high satisfaction rates among members.
Blue Shield is working to create a more transparent healthcare experience for its members. This includes the development of a member health record that combines claims data with clinical data from provider organizations, giving members a single place to access their health history.
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The company has also introduced a price check tool, called Price Check My Rx, which allows members to compare prices for prescription medications and choose the most affordable option. Shah notes that this tool is designed to provide members with more transparency and control over their healthcare costs, and to help them make informed decisions about their care.
Blue Shield’s Virtual Blue program is currently used by over 400,000 members, and the company plans to expand it to additional members in the coming year. Shah notes that the program has been successful in driving down costs and improving access to care, and that the company is committed to continuing to innovate and improve the healthcare experience for its members.
Personalized Care Support
The company’s efforts to improve the healthcare experience for its members also include the use of personalized guidance and support to help members stay on track with their care. This can include reminders and notifications to schedule appointments or follow up on care gaps, as well as access to providers and nurses who can provide guidance and support.
A key aspect of Virtual Blue is its ability to provide seamless transitions between virtual and in-person care. This is achieved through the program’s design, allowing members to easily move between different aspects of their care. For example, a member can start with a virtual primary care visit and then be referred to a specialist, all within the same platform.
Blue Shield is committed to expanding its virtual care services, with plans to build a platform that benefits all of its members, not just those on the Virtual Blue plan. This will include features such as AI chatbot-type features to answer questions and help triage care.
Member Healthcare Tools
The find-a-doctor feature is one of the most-used on the website. Members can also access their health history in one place.
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