Healthy at 75 – Local Touch Helps Blue Cross Blue Shield of Arizona Thrive

By Gabrielle Fimbres –

The year was 1939. Judy Garland enthralled audiences in “The Wizard of Oz,” Superman flew off the page in his daily newspaper comic strip debut and World War II gripped the globe.

It’s the same year that Blue Cross Blue Shield of Arizona opened its doors, starting small and growing into the largest Arizona-based health insurance company.

Today, the nonprofit has nearly 1.4 million customers, with offices in Phoenix, Tucson, Chandler and Flagstaff. The Tucson office, which opened in 1957, employs about 50.

Jeff Stelnik, senior VP for strategy, sales and marketing, said this homegrown company is dug into the community.

“One of the unique aspects of Blue Cross Blue Shield of Arizona is that all of our employees are located here in Arizona,” Stelnik said. “We have a deep-rooted understanding of the community. Not only do our employees love our company and believe in our company, but they love the community and it shows in how we do business.”

Having 75 years under the belt and strong relationships with Tucson hospitals and physicians allows BCBSAZ to help Tucsonans navigate the rapidly evolving healthcare landscape and the sometimes murky waters of healthcare reform, Stelnik said.

“One of the advantages of having been around 75 years is we have seen a lot of changes, from the old indemnity plans into networks,” he said. “Blue Cross Blue Shield of Arizona was one of the first to have an HMO type of policy. We believe all that has helped us prepare for some of the change that is occurring with healthcare reform.”

He said healthcare reform is “the biggest change to the healthcare system in the United States, far and away.”

“We believe that the law itself will be a little bit of a journey,” Stelnik said. “You will see a continual journey in trying to balance the opportunity that it affords people who didn’t have access to the healthcare system in the past, with the high costs associated with healthcare reform.”

He said the company’s history “allows us to have very good conversations with hospitals and doctors and community leaders. We are the best positioned to be able to help shape the journey and educate individuals on the healthcare reform law.”

Stelnik said reform is expanding healthcare availability through the expansion of Medicaid, which is the biggest growth driver nationwide. Also growing are the numbers of people who can afford healthcare, thanks to federal subsidies and people with pre-existing conditions who cannot be turned down.

Like any new system, there are problems, Stelnik said.

“We are acting as advocates for customers on what is not working for them with legislators and regulators, to help voice their concerns,” he said.

Controlling healthcare costs is among the company’s prime objectives, he said. “We often hear from potential customers that costs have been rising at a rate much greater than salaries have, and that’s a huge challenge, especially in this economy.”

Among BCBSAZ programs aimed at reducing healthcare costs are:

• Mi Consejero Azul, or My Blue Adviser, a unit that Stelnik describes as a “concierge-like unit for our Latino partners.” The program walks Spanish-speaking customers through problems that can arise.
• The Patient Centered Medical Home program offers incentives to doctors who work closely with patients to improve chronic conditions such as diabetes and high blood pressure. “Managing chronic diseases improves the health of patients and saves the healthcare system money,” Stelnik said.
• The Transition of Care program helps customers who are admitted to a hospital avoid unnecessary readmissions. “The two biggest drivers of whether you have a readmission are whether you took your prescription drugs and whether you followed up with a doctor,” Stelnik said. The program follows up with patients after release, resulting in a reduction in admissions and “saving our customers tens of millions we anticipate this year, which leads to lower premiums down the road,” he said.
• A mobile app helps customers find urgent care centers, helping to avoid pricy emergency room visits when urgent care is appropriate, and a pharmacy cost calculator allows customers to compare prescription costs at different pharmacies.
• In 2015, BCBSAZ will introduce a tool that Stelnik described as a cost and quality tool, where patients can review facilities and physicians and view quality metrics, helping customers to make informed choices.

“It’s not all about cost,” Stelnik said. “You need to find the best doctor to give you the right treatment, but cost is a big factor. We can help customers manage their health and wealth.”

Rich Boals, BCBSAZ president and CEO, said staying local allows the company to understand customers’ needs.

“Members can count on local service from an organization that knows them,” Boals said. “And we’ll continue to listen to Arizonans so we can develop products and programs that meet our state’s specific healthcare needs.”

The company expects to grow by 60,000 to 70,000 customers this year and has experienced growth every year for more than a decade, Stelnik said.

This fall will bring open enrollment for the Medicare Advantage program for seniors. The company hopes to branch into Medicaid in the future.

Another area of potential growth is Pima County’s uninsured population of about 200,000.

“We want to be at the forefront of education to these individuals to help them understand the value of insurance, the intricacies, complexities, opportunities and challenges of the healthcare law and the value that Blue Cross brings to the table,” he said.

Joel Johnson, CFO at Paragon Space Development Corporation in Tucson, said the company of 54 employees has partnered with BCBSAZ for health insurance for about a dozen years.

He said Paragon has remained a customer “for many reasons, including the network of quality healthcare providers, employee individual circumstance support, overall health plan design support, collaborative partnership relationship and BCBSAZ’s consistently competitive pricing.”

He said the company provides Paragon with analysis that aids in making decisions and budget planning. “BCBSAZ has been a fabulous and collaborative partner that I would absolutely recommend.”

Making BCBSAZ a solid partner are the employees, many who have been with the company for decades, Stelnik said.

“Statewide, more than 50 employees have been with the organization 35 years or more, and about 150 employees have been with the company 25 years or more,” he said.

He pointed to Jody Chandler, senior VP and chief service officer, who started as a claims processor in 1964, when the Beatles topped the charts with “I Want to Hold Your Hand.”

Some employees are multigenerational, including Matt Wandoloski, VP of strategy and informatics, who is involved in Tucson organizations including Tucson Regional Economic Opportunities and Southern Arizona Leadership Council. His son, Matt Jr., is also an employee.

“We are ingrained in the tapestry that built this state,” Stelnik said. “Our people feel that and it’s one of the reasons they stay.”

While he said the company describes itself as innovative, there is stability.

“We are not a shareholder-owned, for-profit company,” Stelnik said. “That allows us to think five, 10, 20 years in advance and to not shift the company’s priorities to meet shareholder needs. I think employees value that. They know they are working for a company that is going to be around for a long time, and they understand how they contribute to the greater good of Arizonans by improving their health.”