Dec 1, 2023

A look back, a look ahead

It seems like at the end of every year we look back and say “Wow, what a year!”…and 2023 is no exception. From a healthcare perspective, there’s so much we’ve accomplished this year. I’ve now been with BCBSRI for nearly six months, and I’ve been amazed by both the quantity and quality of work underway to help us deliver on our vision of improving health and well-being by leading access to high quality, affordable, and equitable care.

With 2024 looming, I thought I’d take the opportunity to highlight some of our most notable achievements in 2023, and to look ahead to some initiatives and goals for next year. BCBSRI has made healthcare equity a major priority this year, and we will enhance that focus moving forward. Another area of focus is pediatric behavioral health.

Here are some highlights:

  • We launched our first ever Health Equity Report in January with an updated version released later in the year. This extensive report shows adult BCBSRI member data across four racial and ethnic groups, scored and measured against several HEDIS® measures. This resource helps us and our providers identify parts of the healthcare system that work and where it falls short, laying the groundwork for new programs and solutions that support more inclusive, affordable, and accessible care for all.
  • We’re shining a light on pediatric behavioral health. Pediatric behavioral health is a core component of our three-year strategy, which kicked off early this year. By the end of those three years, in late 2025, our goal is to have supported the mental health and well-being of roughly 110,000 Rhode Island youths under age 18. We will get there by collaborating with stakeholders across the state, including our participating providers and health systems, to improve access, awareness, and advocacy around pediatric behavioral health. Two specific initiatives were our funding of Project SUCCESS, an evidence-based program designed to prevent and reduce substance use among you ages 12-18, with a goal of early identification and intervention for behavioral health issues. Another was our creation of a “how-to” guide for parents which addresses best practices to help parents recognize a problem, support their child, find the right care, and locate resources to help.
  • We’re focusing on healthcare affordability, establishing value-based care partnerships with providers. Making healthcare more affordable for our members is a key driver of our 2025 strategy, and an important piece of our vision. One of the ways we’re doing that is by establishing value-based care (VBC) arrangements with providers, which create exceptional value and emphasize proactive, preventive care with a focus on keeping patients healthy. VBC programs are designed to lower costs and help Rhode Islanders achieve better health outcomes.
  • We’re advancing equity through colorectal cancer screenings. We’ve partnered with the Lifespan Community Health Institute (LCHI) to provide colorectal cancer screening outreach and navigation assistance to BCBSRI members who are experiencing gaps in getting this critical screening. This partnership will help to reduce measured disparities in CRC screening by race and ethnicity among BCBSRI members, as well as help increase the overall screening rate for all racial and ethnic groups to 80% by 2026.

Looking forward to 2024, there are several key strategic priorities we’re focused on:

  • Transforming care management – Specific priorities include enhancing population health management capability to increase impact across all member segments and optimizing our dual special needs plan (DSNP) health navigator model. Our goal is to work with our providers to dive deeper into members’ conditions and collaborate to develop solutions to address them.
  • Improving health equity – A heavy focus of our health equity initiatives is maternal health. We’ll continue to expand our doula program and our high-risk maternity programs, as well as look to implement other programs with our network providers. In addition, we’ll continue to focus on partnerships to address social determinants of health, expand our colorectal cancer screening initiative (mentioned above), and pursue NCQA health equity accreditation for the first time.
  • Improving behavioral health access and member experience - As mentioned above, we’re planning to positively impact the mental health and well-being of half of Rhode Island’s youths by 2025. We are also working on improvements to access and quality for our members by exploring digital solutions and optimizing behavioral health condition management through improved predictive analytics.
  • Addressing medical costs and easing administrative burden – It’s no secret that medical costs continue to rise, and administrative processes can be a burden and challenge. We’re 100% focused and engaged on issues related to both. Evaluating the health of our members to optimize their health outcomes will help us better manage cost and spending, and we’re dedicated to simplifying processes to help reduce administrative burden for our participating providers.

We’re thankful for your partnership over the last year and looking forward to working closely with you to achieve our goals in 2024. As always, thank you for all you do to help our members stay safe and healthy all year long. Wishing you a happy, healthy, and safe holiday season from all of us at BCBSRI!