Everyone. This is Jacob Emerson with the Becker's
Payer Issues podcast.
Thrilled today to be joined by Colleen Briggs,
who's the president of the Blue Cross North
Carolina Foundation and vice president of corporate responsibility
at Blue Cross of North Carolina. Colleen, thank
you so much for taking the time to
be with me on the podcast today. Thank
you for including me. I'm looking forward to
the conversation.
Likewise. And before we dive into everything we
wanna talk with you about, can you tell
us a little bit more about yourself, your
background in health care, and what it is
that you're doing today at Blue Cross North
Carolina?
Yeah. So I'm I'm from North Carolina originally,
and and I've worked in various roles, both
at the policy level, at the corporate level,
as well as, corporate philanthropy. But most recently,
I've joined Blue Cross around two years ago
to to help establish their corporate social responsibility
division, which is really just responsible for how
do we make sure that we continue to
fulfill our purpose to improve health for all
with clear goals, metrics, and accountability,
and really trying to listen to not only
our members, providers, and communities, but really making
sure that we're building solutions that reflect their
voice, look at partnerships,
that really help drive measurable outcomes that are
improving the health and well-being of our members
and our communities.
Fantastic. So, Colleen, we wanted to get started
today by talking with you a bit about
the company's Feed Your Health initiative.
I think it'd be helpful for our listeners
who might not be familiar with the program
if you could give us a quick overview
of what it is and and how does
this, how do your members interact with the
initiative?
Yeah. So as context, figure health is really
a high touch
personalized approach
to managing uncontrolled
type two diabetes.
So eligible members get medically tailored meals,
culturally relevant groceries,
and one on one nutrition coaching from a
registered dietitian,
all at no cost.
Understood. And so from what I understand, the
program has demonstrated
strong clinical results for you all. A 1.5
reduction in a one c for members with
type two diabetes
over a sixteen week time span.
So talk to us a little bit about
how you're quantifying the return on investment for
a program like this, not just in improved
health outcomes, which obviously are very important, but
in terms of reduced medical spend or long
term value for the health plan itself.
Yeah. And and I do think it is
notable that we are seeing such strong clinical
results. But exactly to your point, what what
that really translates to is lower per member
per month costs, which ultimately drives affordability for
the plan, for our members, and for the
entire health care system. So our own research
shows that these pilots can show a reduction
of a 139
per member per month in total medical costs.
But importantly, we are seeing that it is
improving
participants'
overall well-being.
We're seeing decreased food insecurity,
lower body mass index, and improvements in mental
and physical health, again, outside of just those
a one c reductions.
And the reason that matters is that we
know these are drivers that ultimately influence long
term health care costs.
So by helping members meet these nutritional needs,
manage these chronic conditions more effectively,
we're reducing the likelihood of costly complications,
ER visits,
and, ultimately, really, that all goes back to
savings for our members and, ultimately,
the overall system.
Absolutely. No. It makes a lot of sense.
And, Colin, I wonder you know, we we
we talk to a lot of insurers and
all over the country, we we do see
these last few years, many of them have
been testing food as medicine centered pilot programs.
But but often, they do have issues scaling
them meaningfully across their entire populations,
or or across different market segments. So from
where you sit and from what Blue Cross
of North Carolina has seen so far, what
are some of the key operational or financial
level levers that enable a program like this,
Feed Your Health, to move
from a a a pilot to a sustainable
benefit? What are you seeing out there as
some of the barriers that the industry itself
that that they're facing with these kind of
with these kind of programs?
Yeah. And it's a great question. And I
will say what really has been successful with
Feed Your Health is that it was very
deliberate on the design and the coordination
across clinical teams, food vendors, and community partners,
but it all started just by listening to
our members, to providers,
to to communities. And we actually toured all
100 counties, and one message was clear across
all of those stakeholders
that diet related chronic conditions are hurting our
members, our communities, and they're ultimately driving up
health care costs.
Here in North Carolina, chronic
conditions like heart disease and diabetes
are a leading cost driver,
and they're ultimately
costing our system 65,000,000,000
in medical costs
by 2030. So and we continue to see
this. Our system of care
misses so many opportunities to address
these chronic conditions early on. And for example,
poor nutrition is at the top of the
list of drivers of poor health outcomes.
So based on these insights,
future health was offered really tailored
specifically to address chronic condition management
for with very clear eligibility.
The criteria was very specific that we were
looking at members who are 18 or older
with an a one c of eight or
higher.
Again, at no cost, but I think that
those very specific parameters really did help make
sure that it was successful.
But we also made sure that the program
was scalable, that we were really looking at
how could we make sure that we're partnering
with providers and with our community partners to
make sure that this is really reaching the
next level. But to your point there are
some significant barriers that remain.
I'd say sort of the big four that
we've seen
is first the lack of standardized reimbursement models.
Now nutrition interventions, as you know, often fall
outside of traditional medical co codes making it
harder for us to integrate into some of
the claims system. But, again, that's why we've
been able to really think about how how
do we make sure this is easier for
our commercial health plans, and we've been able
to do that for both Feed Your Health,
but also through some of our other offerings
like our preventative care visits that we offer,
up to 30 of those with a licensed
dietitian at no cost. I think the second
big area that we see as a barrier
is just the limited data on ROI and
outcomes.
So while we see these early studies show
promise, as you know, payers want robust longitudinal
data proving that food is medicine, programs reduce
health care costs, and improve outcomes.
That's why we're tracking and trying to share
our results
like this as well as future reports that
we're gonna continue to issue out really with
the goal of hoping to increase adoption with
this research.
I'd say the third big challenge is just
the operational complexity. It requires a lot of
coordination across clinical teams, food vendors, and community
partners.
And so we've really tried to build this
in a way that does make it easier
for all of those actors to come together
to coordinate and streamline the delivery and the
adoption. In fact we even work with local
partners
through our nonprofits and others to make sure
that it's actually locally sourced food and that
it's culturally relevant and more likely to be
adopted.
And then I'd say again, the fourth barrier
that I see is really just around member
engagement. You know, behavior change is hard,
and some members might resist dietary changes, especially
if it feels like programs are prescriptive.
So that's why all of our programs really
try to reflect the insights from behavioral science
and our partners
to really understand what's gonna lead to behavior
change, which means making it culturally relevant, making
sure that our interventions are actionable,
that they're timely when someone's actually thinking about
it, but also that it's ongoing. It can't
just be one moment in time. We know
that behavior change takes time to really lead
to that lasting outcomes that we wanna see.
Absolutely. You you explained that really well, Colleen,
that this is a very complicated
issue. People don't change their behaviors very easily.
There's limited data on this, and then these
these programs don't necessarily fit into our current
reimbursement and claims
system. So
given all of that, where do you see
food based interventions fitting into a broader benefit
strategy
moving forward. You mentioned how to grow this
more into a mainstream offering in in more
commercial employer sponsored plans. What what does that
look like from your perspective? And is there
anything,
given some of these challenges that you laid
out for us, is there anything regulatory
or,
that the policymakers could be doing,
to really accelerate some adoption here? What what
are you seeing in this space?
Yeah. So I we really do believe that
food based interventions will become a core part
of addressing chronic conditions.
And in commercial plans, we've shown that it's
possible to offer these programs
through disease management pathways.
And
according to our data, we are seeing a
high demand. You know, nearly half of commercially
insured members
with uncontrolled type two diabetes
are screened positive for food insecurity,
and that more than half
consistently lack access to nutritious food that's needed
for help. So clearly, the demand is there.
Now I think on the solutions, we're starting
to see scalable solutions that make it easier
to really help address those needs.
So and and I think what you've seen
here is even though we've talked about some
of those challenges that are operational, financial, and
cultural, that we're seeing really effective solutions like
Feed Your Health programs that really are addressing
those head on.
And, you know, I think we're seeing policymakers
as really important partners at the table of
helping accelerate the adoption and support this. So
I actually think there's a lot of exciting
momentum around this space, and I think we'll
continue to see more. And especially,
I do think that we should see a
role that insurers have to really lead not
just by funding, but how do you actually
look at these systemic issues that might be
getting in the way, and how can we
remove those barriers from our side, how do
we build the infrastructure,
And, really, how do we work with policymakers,
community groups, and others to ensure that food
is medicine is really scalable
and that ultimately healthy food is just built
into the standard of care. And so I
think what we're gonna start to see over
the next few years is really what we're
doing right now at Blue Cross, which is
moving beyond pilots
to really building out these statewide and national
level ecosystems that really make food a core
part of treatment.
Certainly. And and what you just said, Colleen,
really does match with what we are seeing
nationally, what we're hearing daily from insurers that
they're putting the infrastructure in place now. The
momentum really is building. We hear about food
as medicine consistently now. And and it seems
like over these next few years, to your
point, this is something that is really going
to be continuing to take off. So it's
it's really wonderful to see, Blue Cross of
North Carolina,
leading the charge here. But I wonder you
know, you've got the ears of a lot
of other health plan leaders from all over
the country, some insurers
more further along than others in this kind
of, space.
What would be your final thoughts for them
or or final bits of advice as they
continue
on similar journeys?
Yeah. You know, our health care system really
excels at treating acute medical issues and managing
symptoms.
But I think what we're seeing is just
this opportunity for insurers, providers, employers, and communities
leaders to really come together and collaborate to
address some of the root causes of poor
health.
By investing in this kind of preventative full
person care, we can continue the shift from
just reactive treatment to really proactive wellness
and ultimately help the people we serve not
just get healthy, but really stay healthy.
And I think that's why you're seeing what
we're doing is trying to think really broadly,
not just how we help individuals make healthier
choices,
how we integrate
food into health care,
and, ultimately, how do you improve access to
nutritious food. So we're really trying to tackle
this from kind of a holistic,
multipronged strategy
called our health through food initiative because these
are all interconnected pieces. And if we do
it together, we can really start to move
the needle
and show how investing in nonmedical approaches
to preventing, treating, and managing chronic conditions
can ease the burden on our health care
system,
can lower costs for the plan, and for
the broader, you know, system that we all
operate in. But ultimately, most importantly, why we're
all in this business
is it can help the people that we
serve ultimately
enjoy healthier lives. So, again, I think there's
so much exciting opportunities to collaborate and work
together to really get to the root causes
of these issues and really start to move
the needle on not only improving health, but
ultimately driving affordability in the system.
Wonderful. Well, Colleen, I wanna thank you for
taking the time to sit down with us
and for sharing your insights about the important
work going on under your leadership at Blue
Cross. We really appreciate it. Thank you again
for including me.
And to our listeners, if you'd like to
listen to more podcasts from Becker's HealthCare, you
can visit beckershospitalreview.com.