Blue Shield of California is cutting many of its ties with CVS Caremark (though not all) and adding four additional partners for its prescription drug benefits. These partners include Mark Cuban Cost Plus Drug Company and Amazon Pharmacy. The changes are needed to disrupt the current broken system, said Salina Wong, senior director of clinical pharmacy programs at Blue Shield of California.

Peter Long of Blue Shield of California discusses how they focus on member experience and ways to improve their overall healthcare needs.

Here is a selection of recent executive hires, exits, promotions and layoffs occurring across the healthcare industry.

Paul Markovich believes in the value of health tech in managing both chronic diseases and in general health and wellness. In this episode, he talks about the company’s Wellvolution platform and the digital tools that are offered there to members, now even to those on Medicaid.

Blue Shield of California’s Wellvolution platform includes programs for mental health, diabetes reversal, addiction and nutrition. Last month, the payer made the platform available to its Medi-Cal members, a process that took two years.

Virta is available this month to all Blue Shield of California members enrolled in preferred provider organization plans for individual and family, fully insured, self funded and Medicare Advantage. The payer has been working with Virta since 2019 when the digital health company joined Blue Shield of California’s Wellvolution, a platform of digital lifestyle apps.

Blue Shield of California’s new health plan, Virtual Blue, gives members virtual access to primary care through Accolade and virtual access to specialty care through TeleMed2U. If needed, they can also receive in-person care through the payer’s PPO network.

The companies will build their claims processing platform on Google Cloud’s infrastructure, leveraging artificial intelligence and machine learning capabilities. The goal of the collaboration is to improve patient and provider experience and reduce spending on administrative processes.

Cigna Ventures and Blue Shield of California contributed to a funding round for Cricket Health, a startup that provides services to help patients identify chronic kidney disease and get support in treatment. The investment was led by Valtruis, a firm that invests in value-based care companies.

Blue Shield of California is partnering with digital health startup GYANT to roll out Covid-19 screening tools to hospitals in its network for free. Hospitals can deploy the tool on their websites, without having to integrate it with their health record systems.

Blue Shield of California is waiving out-of-pocket costs for members accessing telehealth services through Teladoc. The change will apply to members of its commercial plans.

Accolade, a platform designed to boost employee engagement with their health benefits, filed preliminary paperwork for an IPO. The company plans to be listed on Nasdaq as ACCD

“We realized that that the old way of doing things – which was identifying a single point solution and putting that out to members – wasn’t going to work,” said Bryce Williams, Blue Shield of California’s vice president of lifestyle medicine.

Recently, the San Francisco-based health plan reported positive results that showed a 56 percent reduction in overall opioid use among members with chronic, non-cancer pain from 2014 levels.

A report from Rock Health on streamlining enterprise sales in digital health found that more than half of CEOs (54 percent) admitted to doing “very little” or just “moderate” research on the would-be customers they pitched. Cue facepalm. 

An amendment to the bill would allow states to roll back key consumer protections in the Affordable Care Act, including the popular provision that prohibits discrimination against patients with a history of illness.

Blue Shield of California CEO Paul Markovich expressed concern that president-elect Donald Trump’s support for cross-border insurance sales will push health plans to find the regulatory body or state with the fewest number of regulations.