Key Factors in the Affordability of Care is a four-part quarterly series that addresses broader industry trends affecting healthcare costs. In Part 1, we explored the impact of prescription drug costs, specialty medications and Big Pharma. For Part 2, we asked Matt Hunt, vice president of customer experience at Blue Cross, for his perspective on how Blue Cross can take on rising healthcare costs while still delivering a satisfying member experience.

I’m a big believer that a better consumer experience can do a lot to help keep healthcare costs in check. In fact, I see it happen every day at Blue Cross.

In 2023, my team and I introduced a new technology tool called Blue Care Advisor. We wanted to build a “digital front door” – a one-stop destination where members can easily access and understand all aspects of their Blue Cross plan encompassing claims, benefits, deductibles, health and wellness programs and customer service. But more than being a member experience solution, Blue Care Advisor has capabilities to make a member’s health care dollar go even further.

It all comes down to data. Through data modeling and Artificial Intelligence (AI) analysis, Blue Care Advisor can place a member into a range of categories based on their profiles and health history – and then recommend a proactive “next-best-action” that is specific to them as a person.

Understanding – and following – one’s best next step can reduce healthcare spending in a variety of ways. Within the tool, members are given prompts for health and wellness programs that they otherwise may not have known were available, such as diabetes prevention groups or resources to quit tobacco use. Members are also prompted to engage with their preventative care benefits, such as mammograms, wellness exams and colorectal cancer screenings. In most cases, these services are provided with no cost sharing. Taking advantage of these proactive opportunities is proven to lower total cost of care by identifying conditions early, before treatment becomes a significant financial burden. And it’s working – our latest findings show that members using Blue Care Advisor regularly are twice as likely to schedule these kinds of appointments.

While this technology is truly cutting edge, AI is only as good as the information it learns from. Context surrounding the data is key in avoiding unintended bias in the next-best-action recommendations feature of the tool. New this year, members will be able to volunteer supplemental, self-reported information in their profiles that will allow Blue Care Advisor to deliver an even more meaningful, personalized and equitable experience – and have a positive impact on their wallets.

In many service industries, good experiences and affordability tend to be at odds with each other. Oftentimes, choosing to improve one comes at the expense of the other. As someone who has dedicated my career to creating optimal consumer experiences, I can proudly proclaim that with Blue Care Advisor, both are possible.

Over the last year, we have enabled all commercial plan members to have access to Blue Care Advisor, with more than a million eligible users. I’m committed to ensuring that the tool continues to be revised and updated by what we hear from real people and what we teach the technology to value. With a health plan that embraces the best of what technology has to offer with a very human-centered approach, members can navigate an increasingly complex healthcare ecosystem more easily and more efficiently.

To learn more about Blue Care Advisor including account registration, visit www.bluecrossmn.com/members/member-resources/meet-blue-care-advisor