The insurer, which operates Blue Cross and Blue Shield plans in 14 states, has a three-prong focus as its business model changes under healthcare reform: bringing down the total cost of care, collaborating with providers and improving consumer satisfaction.
“What is different going forward is that we’re transitioning from B-to-B (business-to-business) … to B-to-C (business to consumer),” Swedish said at an event sponsored by the Nashville Health Care Council, an industry group. “We believe that we’re moving into a retail world. What we want to build is stickiness. We build loyalty based on being a brand they respect-that is being a retail business.”
That means he spends more time thinking about the company’s culture “than even diving into our financials,” Swedish said.
But that brand recognition has paid off financially. It allowed Anthem, formerly known as WellPoint, to capture 11% of exchange sign-ups last year, or 780,000 members, even though its health plans weren’t the lowest priced in any of its markets, Swedish said.
Asked about a year-over-year comparison, Swedish said it’s too soon to provide figures because enrollment is still ongoing. As of year-end 2014, the number of beneficiaries enrolled in its exchange plans had fallen to about 710,000 because some people stopped paying their premiums, he added.
Competition for consumers has become more important in a B-to-C environment, but one group Swedish doesn’t want to compete with is providers.
The former CEO of Trinity Health said 50% of providers indicate that they are planning to create some sort of insurance product. “Well, it’s no secret, I’m not a big fan of that,” he said. “I lived through the ’90s. I saw the damage that risk-bearing puts on delivery systems that couldn’t support it.”
When providers go it alone, they take on all of the risk but get none of the reward, he argued. “That’s where shared risk comes into play,” he said, pointing to partnerships the insurer has forged in Wisconsin with Aurora Health Care and in California with seven health systems through Anthem Blue Cross Vivity.
In addition to partnerships, Anthem also expects more of its business to come from the government after the CMS pledged last year to move 50% of its spending into value-based contracts within the next three years.
While the majority of the company’s accountable-care organizations are commercial, Anthem expects a rebalancing as the shift occurs. About two-thirds of its membership already are subsidized by the government in some way, Swedish said.
One challenge of creating value-based care models will be culling through the massive amounts of data-about eight petabytes worth-that Anthem collects, he said. A petabyte is a measure of digital data much larger than what most people are familiar with. A petabyte has been estimated to be between 3.5 and 4 times all the data in the Library of Congress, which means Anthem has between 28 and 32 times all the data in the Library of Congress in its 8 petabytes of data.
“I like to say, we’ve got oceans of data and puddles of useful information,” Swedish said. “Sharing data is gestational-we’ve got a ways to go. It’s coming on line, but we’re still learning as we go.”
http://www.modernhealthcare.com/article/20150402/NEWS/150409964