OAKLAND, Calif. & San Francisco (September 13, 2023) – Blue Shield of California and Salesforce (NYSE: CRM), the No. 1 AI CRM, today announced an expanded collaboration to meet members’ need for unified experiences by leveraging the agility and breadth of the Salesforce platform. With its adoption of Salesforce Health Cloud, Blue Shield of California will be able to expand and scale more in-depth care management services to its members, promoting higher quality care. Additionally with Salesforce, Blue Shield is bringing together a consistent enrollment experience for employers and brokers to reduce the processing time for benefits administration from 24 hours to just five minutes.
“Our goal is to improve how we engage with and care for our members across their interactions with Blue Shield of California and we now have a platform approach that allows us to create unified member experiences,” said Bill Giard, vice president of Enterprise Architecture and Health Innovation at Blue Shield of California. “Salesforce’s scalable, integrated technology allows us to understand our members better, bringing Blue Shield’s reimagined care experience to life.”
“With a growing member base and increasingly complex medical cases, Blue Shield of California needs a holistic, unified view of its members to customize care plans and address health challenges across every step of its care journey. We’re thrilled to help Blue Shield create a more nimble, integrated care management platform to unify member data across multiple sources and collaboratively identify goals and interventions to have better outcomes and lower costs,” said Amit Khanna, senior vice president and general manager, Health and Life Sciences at Salesforce.
Managing Care with Unified Sources of Authorized Data
To gain a unified view of the health status of its members, Blue Shield of California and Salesforce created Care Connect, a clinical care management system built on Salesforce Health Cloud. By combining data from 13 disparate, authorized sources of information, Blue Shield’s care managers can spend more time connecting with members with complex care needs by looking at just one complete view of members, including authorized clinical, lab, pharmacy, behavioral health, care gap and other key member health data. This unified source of authorized data also helps Blue Shield’s nurses, social workers and a member’s providers develop near real-time, holistic care plans and ensure a member is connected to all of their in-network benefits.
“Care Connect allows Blue Shield’s clinical care teams to better understand our members and provide holistic care support through a new, integrated source of truth. This game-changing technology has helped us reimagine how to provide personalized and simplified healthcare experiences for our members,” said Tracy Alvarez, vice president of Medical Care Solutions at Blue Shield of California.
Blue Shield has quickly scaled to double the number of members served through Care Connect and plans to continue enhancing the platform to serve more members and foster adoption by external partners.
KPMG played a key role in the strategic direction of Care Connect and the integration of data sources from across Blue Shield to support care management for member populations.
“Collaborating with Blue Shield of Calfornia and Salesforce enabled the team to build a truly innovative platform, elevating the member care experience through Care Connect,” said Paul Hencoski, Healthcare and Government Solutions practice leader at KPMG. “By leveraging authorized data, unique insights and industry expertise, we can inform client strategies and help build solutions that improve healthcare access. Supporting Blue Shield in transforming the future of care in California represents a core focus and commitment for our team.”
Streamlining Enrollment for Employers and Brokers
The enrollment process for commercial markets has traditionally been manual and paper-heavy for payers and brokers alike. Blue Shield and Salesforce streamlined the end-to-end enrollment lifecycle into a single self-service digital experience for employers and brokers. By eliminating siloed tools and improving accuracy, employers and brokers can ensure their employees have faster access to care with Blue Shield.
With the new automation capabilities, digital enrollment increased by 75% and manually-reviewed group enrollment decreased by 50%. The scalable solution will help Blue Shield expand self-service capabilities and quickly adapt to ever-evolving market needs for care and services.
About Blue Shield of California
Blue Shield of California strives to create a healthcare system worthy of its family and friends that is sustainably affordable. Blue Shield of California is a tax paying, nonprofit, independent member of the Blue Shield Association with more than 4.8 million members, over 7,500 employees and more than $24 billion in annual revenue. Founded in 1939 in San Francisco and now headquartered in Oakland, Blue Shield of California and its affiliates provide health, dental, vision, Medicaid and Medicare healthcare service plans in California. The company has contributed more than $97 million to Blue Shield of California Foundation in the last three years to have an impact on California communities. For more news about Blue Shield of California, please visit news.blueshieldca.com. Or follow us on LinkedIn, Twitter, or Facebook.
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