For some people, insurance is a card that lives in their wallet. It allows them to see their doctor and reduces the cost of their prescriptions. They may not think about it much in between.
That’s not the case for members of BlueCare Tennessee, a BlueCross BlueShield of Tennessee subsidiary serving TennCare members.
“Before our members get to know us, they tend to see their insurance company as a means to an end,” says Jeremy Scruggs, health promotion manager at BlueCare. “But we’re here to help Tennessee’s most vulnerable populations. That means being here all the time, finding ways to help our members live a healthy life.”
BlueCare’s mission is to improve the lives of Tennessee’s Medicaid population by connecting them with essential health care services, treatment and providers — as well as all of the support needed to ultimately reach that care.
A BlueCare team member might start the day by connecting a low-income pregnant woman with prenatal care and, after lunch, help a senior with mobility issues find transportation to and from doctor appointments. It’s not unheard of for team members to spend hours helping a member get their lights turned back on, only to then pivot to working on a school library initiative.
“Data shows that kids who don’t learn to read early in life are more likely to have bad health outcomes,” Jeremy says. “We use information like that to help guide initiatives and address social determinants that our members may not always know about but are visible in their community or children’s schools.”
Remedying risk factors
Many BlueCare members face obstacles that prevent them from focusing on their health. From housing to transportation, food to childcare, BlueCare teams know these needs must be met first before a person can think about joining an exercise class or scheduling a doctor’s appointment.
That’s why Jeremy spends most of his time in communities across Tennessee, learning exactly what members need and finding ways to address those needs. BlueCare uses data and predictive modeling to identify groups with common health and social needs, allowing them to zero in on Tennesseans who need help the most.
Then, to connect with those populations, Jeremy convenes meetings with BlueCare advisory boards across the state. These advisory boards often include:
- People with behavioral health challenges
- People with intellectual or developmental disabilities (Employment and Community First CHOICES)
- Seniors and adults with physical disabilities who need help to continue living at home (CHOICES), as well as those who require long-term services and support (LTSS)
“We meet at a central location within a community,” Jeremy says. “We serve lunch, talk a bit about our programs and benefits, and discuss current issues. Our members give feedback on how those services are going and offer recommendations to make them better. We also bring in providers or community agencies and hold focus groups — anything we can do to make sure our members have a say in the programs they use.”
More than a meeting
These ongoing conversations yield a variety of results. For example, after meeting with a group of seniors, Jeremy’s team learned their biggest challenge was finding a way to attend the meeting in person.
“So many of our seniors use wheelchairs or have no access to transportation, but they still want to play a part in their community,” he explains. “So we made their advisory board meetings more like ‘senior socials’ where they can get education, play games and meet new people. Isolation is a huge health challenge, especially during the COVID-19 pandemic. It’s been so gratifying to help our seniors break out of that and connect with friends — old and new.”
Since the pandemic prevented many seniors from having vital face-to-face interaction with family and friends, the BlueCare team addressed that challenge by conducting virtual community meetings and educating members in advance on how they could participate these conversations.
BlueCare solutions change with each population, and with each challenge. With COVID, for example, BlueCare continues to meet member needs as they arise. Actions they’ve taken include:
- Helping with food distribution when COVID began and kids weren’t in school. In Hamilton County, they placed coolers stocked with sack lunches at bus stops so kids who rely on free school lunch wouldn’t go hungry.
- Inviting doctors and representatives from the Tennessee Department of Health into community meetings. There they discussed the importance of vaccines, addressed hesitancy and shared data.
- Contacting mobile vaccine providers after hearing that vaccination sites were difficult to access. These providers then offered shots in more convenient locations.
- Holding grief workshops for members with behavioral health challenges. These helped ensure vulnerable members don’t slip through the cracks.
“It’s incredible to see the creativity this team uses to get resources to members in need,” Jeremy says. “When a tornado hit Hamilton County, we worked with schools to get food, tarps and diapers to people within days. At our last Habitat for Humanity build in Nashville, we got to meet a woman whose apartment we were building. She happened to be a BlueCare member, so we helped her set up her well-child visit while we were there.”
“You always think you’re alone until you see the support that arises from a need. Seeing strangers come together to help each other still surprises me. And I’m always so proud of how our communities step up.”
Connecting with creativity
Building these connections takes a concerted effort. Keeping up with available community resources can be difficult, even for a big operation like BlueCare. So they partnered with a vendor to create a statewide platform to give everyone access to up-to-date information.
“We’re putting kiosks in schools where families can search resources to find what they’re looking for, whether that’s clothing, food, shelter and so on,” Jeremy says. “The search is confidential, and it will send that information right to their phone, including directions. Currently, the kiosks are in four different schools in Hamilton County, and we’re working to put one in Erlanger Hospital.”
The day-to-day difference
For Jeremy, working at BlueCare is all about balance. His job allows him to push health care forward while still making personal connections and being part of something bigger. He’s thrilled any time his team’s work is recognized, as it recently was when the National Committee for Quality Assurance awarded BlueCare a 3.5-star quality rating. But it’s seeing the positive, incremental changes in members’ lives firsthand that’s kept him inspired at BlueCross for more than 15 years.
“I love that I never know what the day will bring,” Jeremy says. “One day I’m giving a child school supplies who didn’t think they’d be able to afford them. The next I’m hearing from a family whose well-child visit revealed their child needed glasses.”
“We work hard to get our members whatever they need. For me, there’s nothing better than being able to help them through a hard time.”