Transformation: from Health Care to Health Solutions

Posted on Oct 14th 2013 by Pat Geraghty

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Adroit students of the US healthcare system understand that its long-term viability requires significant change.  Curing the system’s ills requires significant change from key stakeholders -- from payors, physicians and hospitals to large and small employers, from brokers/agents to individual customers and patients. The revolution, if you will, to create cost-effective, quality-oriented, consumer-responsive healthcare will involve a change across all components of the system. From one payor’s perspective, Florida Blue, Florida’s Blue Cross Blue Shield plan, this transformation required a shift from being a health insurance company focused solely on financing to being a health solutions company in which insurance was only one component of how to address health in the state.

So what is a health solutions company and how does it address the system change we need?

Florida Blue’s answer begins with retail centers – we operate 11 today and will be expanding to 17 across Florida this year.  These centers allow members and consumers to have a personal experience that helps them understand the system and provides decision support for cost-effective, quality care.  Consumers have face-to-face consultations about their policies and resolve claims issues, receive a health risk assessment resulting in a health and wellness plan tailored to their individual needs and participate in wellness lectures and activities such as yoga and exercise classes.  Consumers buy health plans, Care Consultants help them understand benefits and treatment choices that save time and money, and the trained staff helps individuals research hospitals and providers, compare drug costs to get the best savings, and help them take advantage of member discounts.  The retail centers are so popular that customers give the experience a 92% satisfaction rating and individual customer retention is at 91% -- unheard of levels of satisfaction in this business. The retail centers have hosted a large number of seminars and educational meetings on the Affordable Care Act and have several thousand meetings scheduled across the state to facilitate enrollment in the Marketplace. These centers are also used by their surrounding communities in a variety of ways from hosting Medicare information sessions to serving as the start and finish line for 5K runs; from offering reading programs for at-risk youth offered by Florida Blue and community partners to health fairs sponsored by diverse community groups. The Florida Blue Centers put a face on the company and facilitate a distinct health experience for thousands of customers – many of whom have increased personal responsibility and financial accountability for their care. florida blue retail centers Our health solutions journey includes opening a fun, interactive health and wellness site in partnership with Walt Disney Imagineering called Habit Heroes at Innoventions in Epcot at Walt Disney World Resorts.  The site gives children a fun way to play while learning about nutrition, activity and hydration.  The game can also be played online so it can reinforce and grow the messaging while holding the interest of young game-playing participants. Innovation is in our DNA at Florida Blue fueling our health solutions journey. One Florida Blue example includes Healthbox, a platform that helps launch new health care-related companies like eTect, that has created the ID-Cap, a real time medication adherence monitoring system that includes ingestible wireless sensors and a wrist watch style readers. Additionally, Florida Blue is a founding partner of the Lake Nona Institute in Orlando, a non-profit organization designed to drive innovation through health care in areas including medical science, nutrition, wellness and health care technology. This month, Florida Blue will begin construction of the Florida Blue Collaborative Imagination Center at Lake Nona -- another important way to innovate and collaborate with diverse stakeholders to improve health care. Collaborating with the delivery system, Florida Blue has partnered with seven Accountable Care Organizations (ACOs) encompassing 2,500 primary care physicians to transform the payment system from volume-based fee-for-service (the more you do the more you are paid) to value-based reimbursement, paying providers for efficiently achieving high-quality outcomes. In these arrangements, providers are paid more only if quality standards are met, and they are incented for efficiency -- but only if the quality outcomes are achieved.  This shift from volume to value allows us to reward what any of us would want for ourselves – high-quality, efficient health care. The story of our evolution to a health solutions company would be incomplete without highlighting the invaluable work of the Florida Blue Foundation that supports increased access, quality care and affordability through game-changing investments in all Florida communities. The Foundation has provided 2,500 nurses with scholarships helping to support the tremendous need for nurses across the state.  In Tampa, our grant to Feeding Tampa Bay, allowed the food bank to replace the refrigeration infrastructure enabling them to provide fresh food to those in need.  Since literacy and health status are so closely linked, the Foundation has partnered with the Orlando Magic and the Miami Heat to address childhood literacy.  Reading to children in our communities with sports role models makes it fun and engaging and creates a path for lifelong learning.

Why take the health solutions approach?

We have a major stake in our community.  Our company mission is: To help people and communities achieve better health. We are confident that by achieving this mission we will improve the lives of those who call Florida their home, improve the cost, quality and access equation in our state and continue to play a key role transforming the health care system.

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Pat Geraghty

Patrick “Pat” Geraghty is president and chief executive officer (CEO) of GuideWell Mutual Holding Corporation, Florida Blue and GuideWell Group, Inc. GuideWell is a mutual insurance holding company and is a family of forward-thinking companies focused on transforming health care. The holding company includes Florida Blue, GuideWell Connect, GuideWell Health, GuideWell Source and PopHealthCare.

Geraghty is active in leading professional and community organizations. He serves as the chair of the Florida Council of 100, a private, non-profit, non-partisan organization of Florida business leaders who advise the state’s governor on how to improve the economic growth of the state and the economic well-being of its residents. He also serves as a member of the board of the National Institute of Health Care Management (NIHCM), a non-profit organization dedicated to improving the effectiveness, efficiency and quality of America’s health care system. Additionally, Geraghty is a member of the Oliver Wyman Innovation Center Advisory Board and serves on the boards of Pardee Rand Graduate School, America’s Health Insurance Plans (AHIP) and Tampa Electric Co. (TECO).In 2016 Geraghty became a member of the Health Governors Community of the World Economic Forum, the international organization for public-private cooperation, and a trustee for its Global Challenge Initiative on The Future of Health.

He holds a Bachelor of Arts from Colgate University and has completed executive education programs at Harvard University School of Public Health and the Wharton School at the University of Pennsylvania.

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