Arkansas Blue Cross and Blue Shield’s Joseph Smith and Jerry Bradshaw explain how an advanced health information networks can improve your health
By Ian Armitage
Arkansans have chosen Arkansas Blue Cross and Blue Shield more than any other company to serve their health insurance needs. Why? Well, for one reason, the company has an advanced healthcare information system which helps the medical profession offer a better service to its members.
As a non-profit, mutual insurance company, Arkansas Blue Cross and Blue Shield, an Independent Licensee of the Blue Cross and Blue Shield Association, is owned by its policyholders. Healthcare is the fastest growing sector of the US economy and Arkansas Blue Cross and Blue Shield offers members the most choices in health insurance — more health plans, doctors and hospitals, service and stability.
With a vision of being the leading provider of healthcare financing, service and information, Arkansas Blue Cross contributes to improving the health status of all those in the communities it serves, right across America. “Together with our customers and healthcare providers, we are working for a state of better health for all,” explains Joseph Smith, Senior Vice President.
Putting the member first
Mr. Smith believes Arkansas Blue Cross and Blue Shield’s strength comes from being an independent, mutual and non-profit health insurance provider, which delivers the best value to customers and the community. “First and foremost, we put the member first,” he says. “We manage for long-term benefit of the communities we serve, not for short-term rewards or gains. We are a financially strong and stable organization and look to serve future generations.”
Arkansas Blue Cross and Blue Shield aims to provide businesses, families and individuals with the best value in health-care financing products, life insurance and health-related financial services. Its services and products are therefore specifically designed to create value, trust, peace of mind and a much improved quality of life.
The interests of its members are central to the decision making process and customers are always kept informed. “An informed customer is the best customer; and our customers are well informed,” comments Smith. Accordingly, Arkansas Blue Cross Blue Shield provides information to allow people to make knowledgeable healthcare decisions and expenditures.
Renowned across the US, the Blue Cross and Blue Shield Brand is second in brand-rating only to Coca Cola. Many factors have contributed to this success, least of which is the organization’s ability to think laterally about the future.
Advanced Health Information Network
For instance, several years ago, representatives from a number of Arkansas health-care systems and Arkansas Blue Cross and Blue Shield envisioned a statewide, seamlessly integrated healthcare delivery system and claims processing and communication transaction system; a revolutionary move at that time.
Such a system connects hospitals of the state with practicing physicians, and the various facilities and individual physicians would be connected to each other, to major employers in their regions and to payers by way of a health-data network. AHIN is the communications tool created to implement this vision.
“AHIN is an online system that provides superior functionality, allowing physicians and hospitals to manage their business functions more efficiently,” explains Jerry Bradshaw, Executive Director of AHIN.
AHIN was one of the first health-information networks in the United States to offer advanced real-time functionality and continues to offer capabilities that are unique within the industry. This functionality is the main reason that Hospitals and Health Networks magazine identified Arkansas Blue Cross as one of the “Ten Most Wired Health Plans” in the country.
“Healthcare information technology is very important to us, and is being driven by Federal Government’s vision for 2014,” Smith adds.
Links for Arkansas Blue Cross information systems provide access to eligibility, claims and claim-status information. This is benchmark technology and enables claims to be handled quickly with increased efficiency. “Links to other Blue Cross and Blue Shield plans provide similar access to this information nationwide,” Bradshaw says. “A unique feature allows claim submission and online, real-time correction of erroneous claims regardless of how they were submitted.”
Simply put, AHIN is a browser-based system — Netscape Navigator or Internet Explorer — which simplifies installation and maintenance. Everything necessary to access the system is already present on most personal computers.
Bradshaw and his team began looking into this technology in the mid ‘90s, pioneering a system that focuses on the customer and their needs. Because of its experience in this field, the federal government has looked to Arkansas Blue Cross for guidance on how healthcare/patient information technologies could be integrated across the United States. The US currently boasts the finest healthcare system in the world, but doctors and patients still don’t have access to comprehensive health information.
“We look to share our lessons learned,” admits Smith. “This has helped begin the national initiative for better integration of technology in the fast-growing healthcare sector.”
Any attempt to eliminate errors related to paperwork and to enable better communication between healthcare providers improves treatment and lowers costs in the healthcare industry. Arkansas Blue Cross and Blue Shield’s system does just that and offers members and the health-care community the opportunity to make knowledgeable healthcare choices.
What else lies behind the company’s success? Well for starters, its work environment fosters personal excellence, growth, flexibility and teamwork. “We believe work is a major part of our lives and should be a fulfilling experience. Personal accountability and responsibility are cornerstones of our philosophy,” comments Smith.
Arkansas Blue Cross and Blue Shield also believe in building and maintaining collaborative, long-term relationships with physicians, hospitals and other providers. These relationships are characterized by a mutual interest in its members and a focus on improving the affordability, delivery and quality of care for its members, and will become increasingly important in the future.
“We conduct our operations with the highest degree of integrity, honesty and fairness,” continues Smith. “We believe in corporate citizenship and work to improve the quality of life for all Arkansans. We celebrate our successes, learn from our mistakes and continually strive to improve.”
Serving the region for more than 50 years
Arkansas Blue Cross and Blue Shield has served its customers for more than 50 years, and in that time has seen the industry evolve considerably. Today, the healthcare market continues to change, at fast pace, and innovations such as AHIN go some way in helping the organization adapt to that, while keeping the members as the focus of its attention.
The need for better information is just one change in a rapidly expanding market, as Smith concludes: “We are witnessing the emergence of a consumer directed healthcare market, characterized by the rise of the individual, new approaches to health management and an emerging senior market.
“Additionally, there is increasing convergence between the health and finance industries, which are coming together in support of the emerging consumer directed healthcare market. This will help facilitate and integrate new systems, providing both a health plan payment and a member liability payment across two separate sectors. One of the things that will be strategically distinctive in the future is the ability to wrap those together in a combined single transaction that gives both the member and provider a consolidated view of payments,” he says.