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11Capital BlueCross is an Independent Licensee of the BlueCross BlueShield Association
NOVEMBER, 5 2015
PAIU HUMAN RESOURCE AND BUSINESS MANAGERS FALL MEETING
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CAPITAL BLUE CROSS LOCAL SERVICE AREA
Capital BlueCross Local Service Area
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LEADING THE CHANGE
Capital BlueCross’ mission is to improve the health andwell-being of our customers and the communities in which they live.
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MEDICAL VALUE = QUALITY. COST. SATISFACTION.
Our Differentiating Medical Value Strategy
OPTIMUM MEDICAL VALUE
Quality Cost Satisfaction
ALIGNING INCENTIVES
Consumer Engagement
Provider Engagement
Employer Engagement
Solution Driver Examples:• Value-Based
Benefits• Live Healthy• Consumer tools• Defined
contribution options
• Capital Blue retail store
Solution Driver Examples:• Provider Service
Organization• Accountable Care
Arrangements (ACAs)
• Consumer tools• Data sharing• Blue Distinction®
Centers
Solution Driver Examples:• Value-Based Benefits• Live Healthy• Consumer tools• Comprehensive
reporting• Defined contribution
options
Medical Value = Quality. Cost. Customer Satisfaction.
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Care Managemen
t Differentiat
ors — Enhanced Collaboratio
n
Certified case
managers and
chronic care
professionals Specialize
d and highly
qualified team
Trained in palliative medicine
Intrinsic Coaching
and Motivation
al Interviewi
ng techniques
Addressing Gaps in
Care
Collaborative care
solutions to complex
cases
On-site, face-to-
face services
when necessary
MEMBER OUTREACH AND ENGAGEMENT
Capital BlueCross offers a full range of clinical programs to your employees.
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HEALTH AND WELLNESS
Free, confidential, online health assessment tool
PERSONAL PROFILE
ONLINE DIGITAL
COACHING
Free, online, interactive health coaching programs
CONSULTATION SERVICES
Consultative support in building a culture of wellness with a dedicated implementation specialist
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ONLINE MEMBER ENGAGEMENT TOOLS AND TECHNOLOGY
Healthwise® Knowledgebase
The Blue365® program is brought to you by the Blue Cross and Blue Shield Association. The Blue Cross and Blue Shield Association is an association of independent, locally operated Blue Cross and/or Blue Shield Companies. Blue365 offers access to savings on health and wellness products and services and other interesting items that members may purchase from independent vendors, which are different from covered benefits under your policies with Capital BlueCross and its family of companies.
On behalf of Capital BlueCross, Healthwise® assists in the promotion of health and wellness by providing educational materials. Healthwise is an independent company.
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MAXIMIZING THE VALUEOF YOUR HEALTH CARE DOLLARS
Save Money While Staying Healthy
*Cost comparisons are built from a historical range of amounts paid to providers. This is not a recommendation or endorsement of any particular health care provider or its service and should not be construed as medical advice. Capital BlueCross does not guarantee that services will be available or will be of any particular quality or cost.
Apple, the Apple logo, iPad, iPhone, and iPod touch are trademarks of Apple Inc., registered in the U.S. and other countries. App Store is a service mark of Apple Inc.
Ways to Save Alerts® is a trademark of Change Healthcare Corporation. On behalf of Capital BlueCross, Change Healthcare Corporation provides health information content and member health platform tools. Change Healthcare Corporation is an independent company.
Ways to Save® is a helpful tool that shows our customers ways to save money on the health care services they use the most.
It is simple. If there’s an opportunity to save money on office visits or treatments, we’ll send an email -- a Ways to Save Alert® -- with the details.
Know the costs.* Make smart health care decisions. Start saving!
If customers prefer text messages, they can follow these steps to get text alerts for savings:1. Register or log in at capbluecross.com2. Go to My Account and click Update My Communication Preferences3. Add or verify mobile phone number4. Check the Text Me box to turn on monthly Ways to Save text
messagesTo opt out of email and/or text alerts, uncheck the Ways to Save Email Me/Text Me boxes.
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CUSTOMER CENTRIC SOLUTIONS
Face-to-face service
On-site care guides
Fitness demonstrations
Healthy-eating advice
Delicious, healthy food and beverages
Open enrollment
meeting space
Our Capital Blue retail store transforms your employees’ health insurance plan into an interactive, in-person health and wellness experience!
Capital Blue is brought to you by Capital BlueCross, an Independent Licensee of the BlueCross BlueShield Association, serving 21 counties in central Pennsylvania and the Lehigh Valley.
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DATA ANALYTICS
The power of an advanced analytics platform to bring clarity to your health plan data.
Theon Care EngagerSM, imagined by Geneia, is designed to make the complex simple, giving you the ability to easily: Make informed decisions Visualize the most critical data Streamline plan management Identify care opportunities Reduce waste and redundancy
TheonSM is a product of Geneia® LLC. On Behalf of Capital BlueCross, Geneia LLC provides health data informatics and analytical support and services. Geneia LLC is an independent company.
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CAPITAL BLUE CROSS KEY DIFFERENTIATORS
Capital BlueCross recognizes that to strengthen our foundation to support our customer and medical value focus, we must continue leading the way today, tomorrow, and for years
to come.
ToolsTools to guide customers toward higher quality care and providing the most cost effective way to meet each individual’s needs.
IncentivesIncentives to our members to increase health care engagement; incentives to providers for better care coordination and improvements in the overall quality of care.
PartnersPartnering with doctors and hospitals by providing accurate and timely data.
1212Capital BlueCross is an Independent Licensee of the BlueCross BlueShield Association
Richard MigashManager, New Business
1313Capital BlueCross is an Independent Licensee of the BlueCross BlueShield Association
THANK YOU FOR YOUR TIME
