BCBSM Deep Dive

Much more to come as I walk down memory lane.
Here are three perspective from three individual business team insiders on our ten years together first surviving challenge, then striving for excellence, and finally thriving in an environment of volatility, uncertainty, complexity and ambiguity.

First Perspective
Things Terry Should Be Known for as a P&L Segment Leader

Terry Burke is a results-driven leader that turned around the Individual Business Unit from a segment on the brink of financial failure into one of the most-profitable segments of the company.

Terry successfully navigated the early uncertainty of Affordable Care Act reform by utilizing a selective-aggressive pricing strategy to capture share early when developing IBU’s new ACA-compliant Qualified Health Plans in 2014. IBU achieved 72% Marketplace market share in 2014. Since then, IBU remained the market leader in terms of market share each year since the rollout of the ACA.

Terry used his individual market pricing expertise to balance early membership gains against positive margin gains later. His stellar financial acumen and stewardship of the business guided IBU to a positive, sustainable financial position over the course of its ACA history.

Terry made the tough decision to keep the PPO open during the 2018 pricing cycle when all other individual plans in the state were closing their PPOs (as well as many across the nation). This decision allowed IBU to bifurcate its risk pool and use the PPO as a “risk shield” in order to keep HMO rates as competitive as possible. The decision also retained the higher risk population in the PPO, which was a significant risk adjustment play.

For 2018, the IBU PPO was one of top receivers of risk adjustment in the nation, ranking 5th highest in terms of risk adjustment dollars received.

Terry was a trailblazer and early adopter that utilized the resources of his business carefully and strategically in order to provide innovative solutions. Built in-house informatics and analytics teams in order to leverage the data and predictive modeling needed to compete at the speed of retail. Early adopter of life-time value analysis and retrospective profitability data to inform pricing decisions and drive targeted marketing/sales activities.

Implemented the enterprise’s first instance of a CRM by standing up Salesforce, allowing for efficiencies across the sales, marketing, and operations areas of the business. Bridged the retail divide by partnering across the enterprise with the Senior Health Services over-65 retail business in order to lend his and his team’s retail expertise and infrastructure to support the struggling over-65 retail portion of the company.

Terry is a deeply caring, empathetic leader who made time to meet face-to-face with every member of his staff on an annual basis. Terry cared deeply about the health of his team and his impact on organization health will reverberate long after his departure.

Second Perspective is primarily from a marketing and marketing innovation view and provides the top line accomplishments for each year.

2012
Created and leveraged segmentation model to increase marketing targeting effectiveness

Conducted campaigns using traditional marketing channels: direct mail, email and outbound phone calls

2013 -2014
Significant increase in marketing budget, including spend on first DRTV spots all in an effort to acquire market share goal

2014-2015
Digital marketing added to media mix while decreasing marketing spend

2015-2016
Implementation of Salesforce and data driven marketing while reducing marketing spend year of year

2016-2017
Focus on profitable retention and welcome strategies to improve the member experience

2017
Launched automated welcome and on boarding campaign across both PPO and HMO platform and networks

2017-2018
Advanced use of Salesforce and internal execution of retention campaigns to reduce overall marketing spend year over year

2018- 2019
Personalized engagement marketing combined with hyper targeted acquisition campaign

Third Perspective is a Top Ten List from an IBU Manager that made significant contributions to the segment and the enterprise. Great stuff.

ONE
Purchased Salesforce, built the skill set within the business segment to build it out and manage it, reducing our dependence on IT and vendors to support sales and marketing, and enabling us to personalize our customer experience and respond to the needs of our customers faster. Built in-house data management staff.

TWO
Owning the market on price and product options during the first ACA open enrollment.

THREE
Eliminated the Managing Agency relationship and empower individual agents to service their customers.

FOUR
Simplified the internal operating structure by creating Operations, Sales and Marketing and Product & Performance Sustainability.

Established clear accountability between the functional teams.

Responded to indications of a low trust culture.

FIVE
Responded to the changing market with more price competitive HMO offerings and narrow networks, and creating a spectrum of product offerings and choices from robust PPO to narrow HMO. Dental and vision offerings created additional stickiness.

SIX
Consolidated enrollment platforms and accepted out-of-the-box rather than custom.

SEVEN
Nurtured young talent and promoted from within. Encouraged introspection and development of self. Promoted reading to support professional growth.

EIGHT
Gave everyone a voice through team meetings, 1-on-1s, etc., blurring the lines in an otherwise hierarchical organization.

NINE
Pushed a group focused enterprise to focus on the needs of the retail segments, putting the member at the center of the business strategy.

Volunteered the IBU to be an incubator for design thinking, pushing the enterprise to do better for our members and undo technical complexity built by group mindset.

TEN
Transformed a money losing segment into a money-making segment, one of the few Blues plans to do so.

Thanks to these team members for their thoughtfulness. Thanks to everyone in the IBU for the kickass effort and accomplishments.
WAY TO BRING IT. I WILL MISS YOU BUT I KNOW YOU WILL ROCK ON!!!