Michael Guyette said he came to Blue Cross and Blue Shield of Minnesota as president and CEO in January of last year expecting to take over a “broken” organization.
His predecessor had lasted only six months, during which time several top-level executives left. As for market conditions, no one in the health insurance business had ever seen it so chaotic, with implementation of the sweeping Affordable Care Act reform law really getting underway.
Now, about 15 months into the job, Guyette reports that he is “having the time of my life.”
As health care delivery and how we pay for it continues to evolve, Blue Cross is clearly ambitious about its role. The vision statement on top of Guyette’s strategic plan summary reads “We will be Minnesota’s health care leader.”
Whether that describes Blue Cross right now is certainly debatable. It doesn’t have as many people enrolled in its plans as it did in 2008, although with a true statewide presence and annual revenue of $10 billion it’s not exactly an also-ran.
Among health benefits brokers and other market observers in the Twin Cities, Blue Cross is known for being a step or two slow in its marketing and plan design.
Guyette said he doesn’t disagree with that. But he also pointed out that picking up the pace of innovation and adaptation to change isn’t the only priority he’s discussed with the board. With three CEOs in three years, restoring a sense of stability also was a concern.
When Guyette started, he made a point within the first couple of months to at least shake the hand of all of Blue Cross’ more than 3,000 employees. The biggest change in its leadership team was removing the chief operating officer position.
He wanted the organization to be flatter. And to move faster.
“Decisionmaking here was focused on getting 100 percent or 110 percent of the information” before making a decision, he said. “We are instilling a culture here where we’re saying go ahead and try new things, pilot [a project], that 80 percent of the information is good enough to make a decision.
“We are trying to move faster. We are piloting more. We are partnering more. We think — we know — that will help us transform health care going forward.”
Guyette’s last job before coming to Eagan to take over at Blue Cross was as president of national accounts for Connecticut-based Aetna, a publicly held, traditional health insurer. He was responsible for the bottom line of a multibillion-dollar health insurance business that covered about 9 million people who worked for big, household-name companies.
Of the “strategic pillars” built into the plan Guyette’s Blue Cross team put together, one he talks about the most is consumer focus. This may sound unremarkable for any business, but by consumer he means the individual in a Blue Cross plan, not necessarily a “customer” like the benefits manager at a big employer who picks an insurer.
More and more of the decisionmaking in health care is falling to the consumer, he said. It’s more than choosing between two different options for insurance based on annual deductibles, but also means making more informed choices for medical care.
“We know how to reach out to those members, we know how to give them information, we know how to connect to them,” he said of the role for Blue Cross. “And, we understand the actuarial risk side very well. We’ve been doing it what, 80 years? That’s not something you can just pick up off the shelf.”
The focus on the consumer is what led to the creation of what Guyette called a “war room” at Blue Cross headquarters with staffers working with providers throughout the state on finding ways to eliminate barriers to effective care. It’s everything from transportation to making sure the Blue Cross member sees the right health care professional the first time.
One example is helping Southern Prairie Community Care (SPCC), a 12-county collaborative in southwest Minnesota that is trying to improve care coordination for people on Medicaid. Blue Cross, through its HMO Blue Plus, is working with SPCC and other stakeholders in the area to identify gaps in the coordination of care in this large rural area.
Asked who is more likely to be an innovation leader in the coming years, a health plan provider like Blue Cross or an integrated clinic and hospital system like Allina Health, Guyette said, “maybe it’s together.”