New Yorkers deserve a health care system that is built with people at the center, providing them the right care at the right time based on their needs. Today, increasing time, money, and resources are needed to reach decisions regarding medical care, complicating the health care system for patients, providers, and payers alike. It’s time to address these challenges and create a new kind of health care ecosystem – one that is powered in service of all New Yorkers.
At Empire BlueCross, the Whole Health Company, we are on a mission to materially and measurably improve the health of every single New Yorker. One of the ways we believe we can contribute to delivering on this mission is by simplifying health care. To do this, we need transparency and collaboration across the health care industry. In the new kind of health care ecosystem we’re proposing, various stakeholders elevate their work together to build proactive partnerships anticipating and delivering care for the people we collectively serve; truly centering the system around the needs of the member.
How would the current system change?
The traditional systems used to make health care decisions are limited in the depth of clinical information they contain. They have stringent processes that limit personalized care, and they eliminate the opportunities for dynamic interactions between providers, insurance plans, care managers, and the New Yorkers they all serve.
It’s time to clarify the role of health insurers and give New Yorkers the system they deserve – a system built in service of them. We propose upgrades that allow us to work more closely with providers. We’re asking for the tools we need to best do our jobs – simplifying health care to ensure access and affordability, so that providers can spend their time doing what they love about their jobs – caring for and healing people.
Today’s systems put a significant administrative burden on providers. The new ecosystem helps to eliminate that burden and uses technology so that providers can focus on the care that’s entrusted to their hands. Bidirectional data integration – including real-time admission, discharge, and transfer (ADT) notifications and full access to electronic medical record (EMR) data – is the upgrade we need to make this new health care ecosystem possible – one where a dynamic two-way communication stream helps us to know when New Yorkers need care, intervention, or to simply know where they are in their health care journey.
We will use ADT notifications to proactively conduct timely interventions and care coordination in order to streamline each member’s experience with the health care system. For example, if a member goes to the emergency room and is admitted to an inpatient hospital setting following a heart attack, knowing about that admission positions Empire to work closely with the provider to provide past medical and prescription information, to review care, and to support the member upon discharge. EMR access means we can better engage in quality management activities, such as chart retrieval, risk management, and audits with less administrative impacts to the provider.
We believe this is the future of health care, and so, Empire is setting a goal to have 80% of our members connected to us with real-time ADT and EMR data by the end of 2022.
Everyone wins
If you’re reading this, it’s because you care about our health care system. You are either a provider, a payer, a broker, an employer, or a consumer of health care in New York. And, what’s great is that there are benefits to what we’re proposing for everyone who cares about our health care system.
There is an opportunity to collectively reimagine decision-making in the health care system as a transparent and collaborative process that is built in service of the New Yorkers we serve. The upgrades we are proposing will improve the decision-making process around medically necessary care, ensuring New Yorkers receive the right care at the right time.
This work is coming into focus for Empire, and we’re beginning to start conversations with our partners across the health care system to set goals and hold ourselves accountable for change. If you’re interested in learning more, I invite you to reach out to us and engage with our team on building the health care ecosystem of the future – a universe New Yorkers truly deserve.
Serving the 11 eastern and southeastern counties of New York State, Empire BlueCross is on a mission to materially and measurably improve the health of New Yorkers. In 2020, Empire BlueCross was named one of Albany Business Review’s Best Places to Work. Additional information about Empire is available at www.empireblue.com and www.linkedin.com/company/empire-bluecross.
Alan J. Murray is president and CEO of Empire BlueCross. He is on a mission to materially and measurably improve the health of all New Yorkers. Through his leadership and expertise, he is determined to power the health care system with game-changing innovation that benefits customers and providers across New York.