Navigating employer health insurance with BCBSND – Grand Forks Herald

Employer-sponsored health insurance (ESI) is the main source of health coverage for non-elderly people, covering just over 60% of the U.S. population, or 164.7 million people, according to

Peterson-KFF’s Health System Tracker

. About 80% of adult workers are employed by a business that offers ESI to at least some employees.

Private health insurance spending increased by 5.9% in 2022 (to $1.3 trillion), which was slightly slower than the increase of 6.3% in 2021, according to data from the Centers for Medicare and Medicaid Services (CMS). For hospital care, physician and clinical services, and dental services, private health insurance expenditures grew more slowly in 2022 following stronger growth in 2021. Private health insurance enrollment increased 1.5%, or by 2.9 million individuals, in 2022 – the fastest increase since 2015.

Blue Cross Blue Shield of North Dakota

is the largest provider of health coverage in North Dakota and insures and/or administers claims for over 310,000 people, the company’s website states. BCBSND is a not-for-profit mutual insurance company whose members have access to all of the hospitals in North Dakota and 99% of physicians in the state. Prairie Business spoke with leadership at BCBSND to learn how the company is addressing the ongoing increasing cost of health care and changes in the market relating to how health care is delivered.

Lacey Bergh, senior vice president of Health Delivery, said employers want to ensure their employees have health-care services that are easy to access, including wellness and prevention, and want to keep that coverage affordable.

“How do you get ahead of people developing chronic conditions is something our employer partners look for us to bring to the table,” she said. “The cost of health care continues to rise and it really is so important as we think about people’s wellbeing.”

The way people access their health-care services has changed since the pandemic, driving the push for technology that allows virtual visits, virtual nursing and advances in health-care facilities.

“During the pandemic, a lot of folks put off preventative care. We haven’t necessarily seen that rebound back to the way it was before the pandemic. What we’re seeing is the need for earlier intervention,” Bergh said.

The company rolled out a digital care management platform this year through which care managers can help BCBSND members. The new platform is an effort to reduce barriers patients may face in accessing health care.

“Rather than playing phone tag to get ahold of people, being able to connect with them digitally has been really fun for our care team. Later this year, folks will be able to self-enroll in that through our BCBSND Care Connect app,” she said.

Kristi Huber, executive vice president and chief marketing officer, said BCBSND is bringing innovation to its members, especially in the digital realm.

“One of the things we’ve been working really hard on at BCBSND is to make sure our members have a wonderful customer experience and they feel that difference of experience through that telecare clinic experience,” Huber said. “In order for us to really lower the total cost of care across the state, it’s about being as efficient and effective as possible.”

VitellaCare Clinics will be a new primary care clinic model in North Dakota. BCBSND’s parent company, HealthyDakota Mutual Holdings, partnered with Crossover Health to launch the clinics. This model of primary care provides a holistic approach to physical, mental and emotional well-being, according to a release. VitellaCare-advanced primary care clinics will offer in-person and virtual access to comprehensive health-care services and proactive health management.

“We’re starting small and hope to expand,” Bergh said of the VitellaCare Clinics. “I think it’s about how you wrap services around patients, around employees, to make it easier for them to take care of their health. We know they benefit – employers benefit, everyone benefits when employees are healthier. The community benefits as well.”

Huber said one of the big concerns they’re hearing from employers is, “How can we engage our members (employees) and truly encourage them to take an active approach to their well-being?”

“One of the things we’re doing to make it easier and more accessible is we’ll be adding a digital app that is truly a consumer-grade level experience,” Huber said, explaining that people are already using apps to research products and save time shopping. The name of the app has not yet been released, but is promised to offer a personalized experience using information gathered through claims data and the ways in which a member uses the app.

“It will provide an opportunity for messaging for reminders to schedule appointments, or if you have challenges, like your A1C is getting high, it will connect you with the Omada program we utilize. It’s about making that next best step available for each person. Meeting them where they’re at to help them engage in their health differently,” she said.

Knowing that not all people enjoy dealing with technology, care guides can be accessed via phone to assist members who have questions about their health-care services.

“Our goal going forward is that we support our BCBSND members wherever they are on their health-care journey – to help them stay well, help them manage chronic conditions, if they have a catastrophic event, help reduce the anxiety and coordinate the care so they have the best outcome possible,” Bergh said. “We need to keep our eye on that as we implement all of the solutions.”

Health care in general needs to ensure solutions are being provided for patients wherever they’re at in their health-care journey, Bergh said. Employers should also be aware they have employees with various health and wellness needs and try to find the best coverage for their teams as a whole.

“We understand that data and analytics are the drivers of being able to provide all that so we’re going to continue to double down and make sure we can provide that information to our members so they can make their best decision. We’re going to continue to innovate in that space, which is going to be crucial to lower the cost of care in North Dakota,” Huber said.