JD Hickey
President & CEO,
BlueCross BlueShield of Tennessee
Evolving our efforts to meet our members where they are
In our 2023 Member Impact Report, we’re sharing how we made strides to more effectively support those we serve on their health journeys.
As you’ll see below, one way is with enhanced virtual care options — including mental health services. For routine preventive care and specialist consultations alike, our increased support of telehealth ensured timely and convenient access to expert advice and treatment.
We’re also shining a light on our continued efforts toward health equity for all Tennesseans and beyond. And our commitment to peace of mind was again validated by industry certifications and higher quality ratings. These accolades reflect our dedication to delivering top-tier service.
Offering affordable health care plans and paying claims is the basis of our day-to-day work. As a not-for-profit health plan, we actively renegotiate with providers to keep them in our networks. The resulting savings go directly to our members and customers in the form of lower premiums.
Looking back at the past year, we remained laser-focused on our work on behalf of our members. But we also know we can continue to improve. We thank you for your continued support and trust in this partnership.
By the numbers: health care coverage
Our mission of peace of mind through better health is achieved by providing convenient, affordable, high-quality care options for our members. While the cost of care directly impacts what we charge members for coverage, we’re also here to cover those health care claims. Here’s a snapshot of our members’ health in 2023 — and how we supported them every step of the way.
Claims processed in 2023
Members with BlueCross coverage
Community engagement, health screening, and outreach events held statewide in 2023
Members educated at these events
Claims costs we paid for our members
Invested to get more mental health providers in our networks
Understanding and addressing health equity
We built on our commitment to understand and address health disparities. Using claims, self-reported and public data, our health equity report identifies the social determinants we see across Black, White, Asian, Indigenous and Hispanic populations statewide that contribute to health disparities.
Our second annual health report includes expanded data around:
- social risk factors
- mental health
- maternal health
About our health equity report
Dr. Andrea Willis, chief medical officer, said the report findings will inform collaboration with health providers to advance outcomes for diverse communities across the state.
“We wanted to get a better picture of the health issues and barriers to care faced by our members and Tennesseans as a whole, so that we could more effectively partner with health care providers to address those issues,” Dr. Willis explained. “Understanding this data helps support progress that will ultimately deliver better health for everyone, regardless of their background.”
Dr. Andrea Willis
SVP & Chief Medical Officer
Sharing thought leadership in health equity
During our Power of We Workforce Diversity Conference, held in Nashville in October, BlueCross Chief Medical Officer Dr. Andrea Willis and Chief Data Officer Sherri Zink discussed our report’s findings, how social factors affect the health and well-being of so many of our members, and the role we all play in working toward more equitable, accessible care for Tennesseans.
Making strides in mental health care coverage
Physical health and mental health are inseparable. In 2023, we reorganized care teams to better address members’ mental health needs. We’re using member outreach to improve mental health outcomes and reduce costly medical events. We’ve also increased reimbursement rates for in-network mental health providers.
Virtual care: a new standard in accessible health care
Telehealth has become increasingly widespread in recent years thanks to its convenience and quality. This option can reduce unnecessary long waits and more expensive bills.
We’ve worked to promote telehealth by:
- partnering with Teladoc, a virtual care service
- integrating it with our BCBSTN mobile app
- sharing with our members common symptoms where a virtual visit is an ideal starting point
Our goal is to encourage our members not only to schedule a virtual care visit when the need arises, but to use our app to help establish an ongoing relationship with a primary care physician (PCP) if they don’t have one.
Donna Pugh
Manager, BlueCare Plus utilization management
Meet our people
Donna, formerly with the United States Army Signal Corps before becoming a registered nurse and serving with the Army Reserves Nursing Corps, joined BlueCross as a case manager in 2014. Now with BlueCare Plus, she follows the same established problem-solving hierarchy that defined her time as a nurse.
“First comes the needs of my members, then my co-workers, and then keeping the company vision in mind. Am I doing everything I can to keep things smooth for the members? Is everything in place for them? If not, what do I need to change, or what do I have to implement?”
Matter of Balance for seniors
We’re helping our senior members develop action plans to stay safe and healthy. Our statewide Matter of Balance classes, offered on site at Blue of Tennessee medical centers and at the BlueCross corporate headquarters, are taught by our expert staff. Senior members are guided through low-impact exercises that help improve balance and prevent falls.
Members who attended statewide Matter of Balance classes in 2023
Having access to convenient, affordable, community-based health care has never been more important. Our primary care clinics offer consultation from onsite BlueCross health insurance advisors who can answer questions about coverage, and urgent and preventive care from providers with operating hours that fit with our members’ busy schedules.
Blue of Tennessee medical centers currently open in middle and west Tennessee
Patient visits managed by Sanitas from January 2023 to December 2023
A lower-priced network for Individual/Marketplace plans
Health care costs continue to rise, and we’re making every effort to minimize the impact on the cost of coverage. We offer a variety of plans for members who purchase health insurance on their own. Last year, we announced that Erlanger Health will serve as the anchor system for our first Network E offering in the Chattanooga region starting Jan. 1, 2024. This partnership expands an affordable model already serving Nashville and Memphis customers.
Lower price for Network E compared to Network S plans
Medicare Advantage 4.5‑star rating
The Centers for Medicare & Medicaid Services (CMS) annually evaluates Medicare plans based on a 5-star rating system. After reviewing our operations, customer surveys and enrollees’ health outcomes across several dimensions, our Medicare Advantage PPO plan earned a 4.5 out of 5-star quality rating, marking the third consecutive year the plan has scored 4.5 or higher.
The most recent ranking emphasized members’:
- timely preventive screenings and health care
- effective management of chronic health issues
- overall satisfaction with their health plan and providers
Distinct performance and quality measures that Medicare Advantage plans with prescription drug coverage are evaluated against by the CMS
Meet our people
Melissa Perry, registered dietitian at BlueCross helped a member take control of his diabetes management.
“Diabetes can be overwhelming,” Melissa says. “I felt it was best for him to start with small changes.”
Melissa reached out to help plan meals, and gave the member small ideas for lifestyle changes. “My goal is to put members in the driver’s seat,” she says.
Instead of telling the member to cut soft drinks entirely, she asked if he could switch to water or zero-sugar drinks with meals. Within a few weeks, the member’s blood sugar had dropped significantly.
“I then helped him connect the dots to see how these changes were making him feel better,” Melissa says.
Melissa Perry
Registered dietician, BlueCross
Serving adults with IDD
BlueCare Tennessee has partnered with Kramer Davis Health, an organization dedicated exclusively to providing whole-person care for patients with intellectual and developmental disabilities (IDD). Based in Nashville, Kramer Davis is designed to provide accessible, high-quality care, offering a wide array of services tailored to the unique needs of the patients we support.
The practice includes:
- dental treatment
- nutrition
- psychiatry
- behavioral health
- physical therapy
- occupational therapy
- speech pathology
Casey Dungan
President and CEO of BlueCare Tennessee
Partnering with Kramer Davis
“You don’t have to work too long in BlueCare to connect with how important our work is and all the different levels and needs of people who require these services. Once you make that connection, everything’s different. The stakes are higher in your mind.”
Months to receive a bachelor’s degree in computer science and potential job offer through BlueSky Institute’s partnership with ETSU
Touting the BlueSky Tennessee Institute model
Other universities are taking note of our work in higher education. BlueCross President and CEO JD Hickey was a guest on Harvard Business School’s “Managing the Future of Work” podcast. He spoke about the evolution of our one-of-a-kind workforce development program and how it’s a groundbreaking way to address a nationwide phenomenon of technology skill shortage.
Corben Smith
Student at BlueSky Tennessee Institute
Taking flight with BlueSky Institute
Corben Smith, a student in our second cohort, shared what brought him to our Chattanooga campus.
“Computer science has always been what I’ve wanted to do. When I was a kid, I told my dad that I wanted a Ph.D. in robotics, even though I had no clue what that meant. Like most kids in the program, I’ve tinkered a bit, done a bit of programming. And I took a computer science course in high school. I’m not coming in completely ignorant, but I’m ready to learn more.
“I’m looking forward to meeting and being around a lot of like-minded people, and generally just learning more about computers, which is something I’ve been passionate about for as long as I can remember. I’m excited to get started.”
Get email updates with the latest news from BlueCross
Get email updates with health and wellness tips from BlueCross experts
©2024 BlueCross BlueShield of Tennessee
BlueCross BlueShield of Tennessee, BlueCross BlueShield of Tennessee Health Foundation, BlueCross BlueShield of Tennessee Community Trust and BlueCare Tennessee are Independent Licensees of the Blue Cross Blue Shield Association. BlueCross BlueShield of Tennessee is a Qualified Health Plan issuer in the Health Insurance Marketplace.
1 Cameron Hill Circle, Chattanooga, TN 37402-0001