Health Reimagined Initiative:
Health Reimagined is Blue Shield of California’s ambitious plan to transform our healthcare system with innovative ideas and new technologies that improve quality while making care more affordable. We’re collaborating closely with medical providers, employers, community leaders, and others throughout the state to make this vision come to life.
Health Reimagined focuses on three categories:
• High-tech, high-touch support
We’re implementing a suite of technology tools
and services to support care that is safe, effective, and efficient, while removing distractions, inefficiencies, and burdens from the provider and member experience.
• Personal care
Our care model is patient-centered, data-driven,
and evidenced-based. It gives patients and their physicians the tools, time, and space to address complex health issues, and supports and rewards better-quality health outcomes.
• Holistic health
By addressing social, environmental, clinical, genetic, and behavioral drivers of health
and connecting members to essential community services, we’re helping improve the
health of our communities.
We have launched multiple pilot programs in four counties throughout California: Butte, Los Angeles, Monterey, and Sacramento. Each of these regions has unique characteristics and needs that will help us understand which approaches are most effective, and how they can be scaled and made available in other parts of the state.
Health Reimagined in Butte County
In Butte County, a rural community in Northern California where the town of Paradise was devasted by the Camp Fire in 2018, access to health care is an ongoing challenge.
Pilot program participant
• Paradise Medical Group
• Virtual care
o Virtual visitsPatients receive customized care virtually through PMG Connect, which allows patients to set up medical virtual visits with their providers at Paradise Medical Group via mobile phone, tablet, or personal computer. The service is available for pediatric and adult patients at Paradise Medical Group.o eConsultationsA provider-to-provider platform, eConsultations allows primary care providers to electronically consult with board-certified specialists covering 70 specialty areas. Providers receive timely advice from specialists through an e-consultation delivered within 24 to 72 hours of the initial request, which they can use to comprehensively address patient-care issues. This approach is highly effective and convenient for both providers and patients.o eTranscription/Virtual assistantVirtual assistant technologies are inuse at Paradise Medical Group to improve the patient experience and automate administrative workflows for physicians. Using smart watches, physicians record and document patient visits. The information is populated seamlessly into electronic health records, helping physicians and administrators save time – as much as two hours each day. Pre-visit technologies offer patients a streamlined check-in process via their smart phone, and post-visit technologies optimize entry of orders and procedures to generate claims that are more accurate.
• Community Health Advocate Program
Aimed at promoting preventive measures to help manage member health and identify health risks, the Blue Shield-funded Community Health Advocate Program provides personalized, in-home, high-touch care, integrated with innovative technology and collaborative communitygroups. Among services community health advocates provide are:
o Acting as a liaison with local community and health care organizationso Coordinating quality healthcare and community resourceso Reducing social challenges and barriers to achieving positive health outcomeso Increasingaccess to services and care coordination
• Innovative payment model
The value-based care payment model with Paradise Medical Group is designed to give physicians the flexibility and financial resources they need to deliver essential and specialized medical services to patients. Providers are accountable for patient-centered outcomes they can control and aren’t burdened with additional administrative tasks. Fundamental to this value-based approach is the opportunity for expanded patient visits and compensation for care-coordination. Expanded visits allow physicians and members of the extended care team to spend more time to examine patients in a holistic way. These visits also enable the care team to see patients more often as their circumstances and diagnoses change (e.g., a significant new diagnosis or change in an existing diagnosis, change in life situation that impacts health, or identification of high-risk health condition).
Blue Shield of California is an independent licensee of the Blue Shield Association.