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Consumers Take Center Stage

Consumers Take Center Stage. 2007 Health Leaders Forum Federal Reserve Bank of Chicago and Detroit Regional Chamber Detroit, Michigan April 24, 2007. Scott P. Serota President & CEO. Agenda. Meet Meredith. The Blues.

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Consumers Take Center Stage

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  1. Consumers Take Center Stage 2007 Health Leaders ForumFederal Reserve Bank of Chicago and Detroit Regional Chamber Detroit, Michigan April 24, 2007 Scott P. SerotaPresident & CEO

  2. Agenda Meet Meredith The Blues Building a Better System Consumers Take Center Stage

  3. The Blues Blues are the strongest Brand in healthcare across America #1 Brand Solid Financials Record Enrollment Quality Provider Networks

  4. Blues Enrollment Blues member enrollment is at an all-time record high Customers (in millions)

  5. International Markets Extending the Brand into high-profile international markets • BlueCard Worldwide offers U.S. customers access to medical assistance worldwide • 7,000 physicians in 200 countries • 850 hospitals in 84 countries • BlueWorldwide Expat provides specialized insurance product for expatriates • 100+ accounts • 700 lives • Blue Brands licensed to independent companies in 50 countries in Europe, Central America and South America • 5.5 million international subscribers

  6. Agenda MeetMeredith The Blues Consumers Take Center Stage Building a Better System

  7. A New Healthcare Model for the Future A true consumer-centric healthcare system for the future should clearly focus on the wants and needs of consumers Current Model Future Model Provider Consumer Employer Payer Government

  8. Shaping a Future Healthcare Model With more than 75 million lives, BHI leads in data scope and depth and is helping shape a future healthcare delivery model • Shaping new care delivery model • Partner with providers on outcomes and care patterns • Robust information for consumer decision-making • Support policy development • State-of-the-art informatics • Precise data • More statistically valid measures • Benchmark data across geographies

  9. Serving Consumer Healthcare Financial Needs Bank supports new Consumer-Directed Health Plans and HSAs, offering consumers integrated and easy-to-use service • Support growing number of Blue Plan CDHPs and HSAs • Easy-to-use, seamless and fully integrated consumer service • Simplify healthcare spending • Full line of financial services • Chartered to serve all 50 states

  10. Agenda MeetMeredith The Blues Consumers Take Center Stage Building a Better System

  11. Better Knowledge for Healthier Lives Helping consumers make more informed decisions while helping providers improve health outcomes and affordability Engaging consumers to enable more informed healthcare decisions Collaborating with providers to improve quality outcomes and affordability

  12. Collaborating with Providers to Raise Standards Raise standards, ensure more consistent quality care Surgical Care Primary Care Medicine Specialty Care Medicine Other Organizations

  13. Higher Standards Mean Better Care Specialty Care Centers focus on most challenging conditions • Bariatric surgery • Cardiac care • Transplants • Cancer care Developed in close collaboration with leading medical providers and specialty organizations

  14. Centers for Specialty Care: Transplant There are 70 evidence-based Blue Distinction Centers for Transplants in local communities nationwide Blue Distinction Centers for Transplants

  15. Centers for Specialty Care: Bariatric Surgery … and 125 Blue Distinction Centers for Bariatric Surgery Blue Distinction Centers for Transplants Blue Distinction Centers for Bariatric Surgery

  16. Centers for Specialty Care: Cardiac Care … and 375 Blue Distinction Centers for Cardiac Care Blue Distinction Centers for Transplants Blue Distinction Centers for Bariatric Surgery Blue Distinction Centers for Cardiac Care

  17. Higher Standards Yield Better Care Short-Term Major Complications for Bariatric Surgery Inpatient Mortality(Heart Attack) SM SM Mean Maximum

  18. Investing in Patient Quality and Safety Example: Partnership with Institute for Healthcare Improvement • Blues contributed $5M to “5 Million Lives” campaign • Campaign aims to protect five million lives through: • Proven infection control practices • Evidence-based practices for congestive heart failure • Deployment of rapid response teams • Reduction of adverse drug events

  19. Agenda MeetMeredith The Blues Consumers Take Center Stage Building a Better System

  20. Meet Meredith Meredith is confronting several serious health problems • “I weigh more than I should” • “I have a family history of heart disease” • “My doctor just told me I need a coronary bypass”

  21. Meredith’s Dilemma A few years ago, Meredith would have had limited options for help in deciding what to do about her health problems • Get advice from friends • Ask her doctor for recommendations

  22. More Options Today With programs like Blue Distinction, Meredith has access to more pertinent information to make informed decisions • Compare bypass centers • Identify success criteria of several hospitals for treating heart disease • Manage costs while seeking best possible care • Connect with and learn from the experiences of other bypass patients

  23. More Useful Consumer Tools on the Horizon Meredith and other consumers like her are helping shape healthcare decision-making tools to enhance transparency • Market testing with hundreds of employees of Fortune 100 companies nationwide • Testing a broad range of cost and quality measures • Identifying consumer preferences for display design • Measuring impact on consumer decision-making

  24. Simplifying Information for Meredith Offer consumers valuable information that is easy to use Accessible logistical information Care-specific clinical quality metrics Benchmarks and thresholds Robust patient satisfaction data Note: this picture is hypothetical and strictly for illustrative purposes

  25. Personal Health Records for Consumers Collaborating with stakeholders to create consumer PHRs Blue Cross and Blue Shield Companies Plan PHRs for 2008

  26. In the Future, Consumers Are Center Stage Picture a consumer-centric, information-driven system Consumer Health Plans Physicians Rx Pharmacy Financial services / tools Labs Health and Wellness Other Providers (e.g. care managers) Hospitals

  27. Consumers Take Center Stage 2007 Health Leaders ForumFederal Reserve Bank of Chicago and Detroit Regional Chamber Detroit, Michigan April 24, 2007 Scott P. SerotaPresident & CEO

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