Tag: excellus bcbs

Excellus BCBS awards grants to address maternal health disparities 

Excellus BlueCross BlueShield announced this week the first round of recipients of Member and Community Health Improvement grants to improve maternal health and health equity in upstate New York.  

Cuyler

Eight nonprofit organizations in the health plan’s 39-county service area will share $1 million in grant funding over the next three years. 

Two organizations in the Rochester region were chosen to receive MACHI grants, including:   

  • Child & Family Resource Center Inc.’s Healthy Families program serving families and young children in Ontario, Seneca and Yates counties. The program offers support services to expectant and new parents, and
  • Mount Hope Family Center’s Building Healthy Children program, providing home-based interventions for teen moms to address maternal mental health, parenting and child development and trauma. 

Earlier this year, Excellus BCBS invited organizations to apply for MACHI grants to fund programs to eliminate racial, health and geographical disparities and that support of the National Maternal Health Equity Strategy endorsed by the Blue Cross Blue Shield Association. 

“We have an opportunity and a responsibility to confront the nation’s crisis in maternal health disparities,” said Gina Cuyler, M.D., Excellus BCBS vice president of health equity and community investments. “With this first installment of award funding, community organizations will have greater capabilities to support safe pregnancies and childbirth, eliminate pregnancy-related health disparities and improve health outcomes for new mothers and babies.” 

Black, Latina and Asian women have higher rates of severe maternal morbidity than white women, regardless of age or type of health insurance, according to a recent study of racial and ethnic disparities in maternal health issued by the Blue Cross Blue Shield Association. 

“New parents will be able to access much needed, concrete health and safety supports, community resources and helpful child development tools that will strengthen their ability to successfully provide a safe and nurturing environment for their infant to grow,” said Julie Champion, Child and Family Resource Center’s executive director. “Investments like this recognize that healthy communities start with healthy infants, children and families.” 

Six additional nonprofit organizations outside of the Rochester region will receive funding and include: Contact Community Services, Gerard Place, Integrated Community Alternatives Network, Jericho Road Community Health Center, Mohawk Valley Health System and Mothers & Babies Perinatal Network. 

[email protected] / (585) 653-4021 

BCBS funding opportunity addresses health disparities upstate  

Area nonprofits can now apply for Excellus BlueCross BlueShield’s Health Equity awards, which help fund health and wellness programs that address racial and ethnic health disparities in upstate New York.  

BCBS funding opportunity addresses health disparities upstate  
Cuyler

The application period is now open and closes at 11:59 p.m. on Thursday, Sept. 15. 

Application proposals must include clear, defined goals for reducing health disparities and improving health equity for people that face a higher burden of health inequities and social disadvantages.  

Organizations will be required to specify how funding will measurably assist in improving racial and ethnic health equity outcomes. 

Proposals that have detailed scope, goals, rationale for support and measures will receive the strongest consideration. Award winners will be announced in mid-November. 

Health Equity categories include, but are not limited to: 

  • Reducing health disparities in racial, ethnic, LGBTQ communities, people with disabilities, people living in rural or urban communities or other groups of people that may be at a higher health risk for: 
    • Medical issues and conditions (chronic or acute); 
    • Behavioral health or mental health conditions, or 
    • Negative outcomes from the above, including death or suicide. 

“At Excellus BlueCross BlueShield, the health of our communities is at the center of everything we do,” said Gina Cuyler, MD, vice president of Health Equity and Community Investments, Excellus BCBS, in a statement. “Together we can confront the crisis in health disparities, embrace and address long-standing gaps in care and bridge health equity gaps in our underserved communities.” 

Visit www.excellusbcbs.com/community for more information.  

[email protected] / (585) 653-4021 

Searles to join Trillium Health leadership team

Joseph Searles has joined Trillium Health as its vice president and chief community engagement officer. He starts his new position on Oct. 25.

Searles previously served as corporate diversity relations director for Excellus Blue Cross Blue Shield. He has been a member of Trillium Health’s board of directors since 2017.

“I’m thrilled that Joseph will be joining our executive leadership team at Trillium Health,” said Trillium President and CEO Andrea DeMeo. “Joseph brings a wealth of experience and dedication to fostering diversity, equity and inclusion; he is well acquainted with our mission, vision and values; and he shares our commitment to barrier- and stigma-free care. Joseph will serve as an important adviser to me and our entire executive and operational leadership teams as we work together to achieve diversity, equity and inclusion both within our culture at Trillium Health and in our efforts to address health equity within the community.”

Searles has nearly 15 years of experience in community relations; diversity, equity and inclusion; strategic planning; and organizational development. A native of Rochester, he has cultivated a broad network of influential leaders in the community, including government officials, municipalities, business leaders, higher education leaders and community-based health and human service organizations.

Joseph Searles

“It excites me that Trillium Health continues to evolve as a premier organization for healthcare, LGBTQ advocacy, diversity, equity, inclusion and access in our communities,” Searles said. “I am equally energized to be joining an organization that has a legacy of serving the LGBTQ community’s health and well-being.”

Searles has been a member of many boards and task forces for local professional organizations, including Trillium Health, the United Way of Greater Rochester and the Finger Lakes, Common Ground Health, YWCA of Rochester Monroe County, Ibero American Action League, Out Alliance, Big Brothers Big Sisters and the Rochester Gay Men’s Chorus.

In his new role, Searles will be responsible for strategic leadership, development and oversight of Trillium Health’s community engagement, DEI and LGBTQ health and education initiatives. Searles and his team will be responsible for building bridges with like-minded organizations and developing and facilitating the implementation of DEI strategies that are aligned with the organization’s mission and strategic plan, with a focus on addressing needs in underrepresented and marginalized communities to achieve health equity.

[email protected] / 585-653-4021
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Excellus BCBS to offer community health grants

Excellus BlueCross BlueShield is offering Community Health Award grants totaling $150,000 to help fund health and wellness programs in upstate New York. The application period closes Friday, March 5.

All nonprofit organizations in Excellus BCBS’ Rochester region can apply for an award of up to $5,000 each. The award can be used for programs that have clear goals to improve the health or health care of a specific population. Any program that aims to improve the health status of the community, closes the gap in health disparities, reduces the incidence of specific diseases, promotes health education and assists our communities in dealing with COVID will be considered.

Award winners will be announced later this spring.

“The company’s Community Health Awards demonstrate a corporate commitment to support local organizations that share our mission as a nonprofit health plan,” said Jim Reed, president and CEO-elect for Excellus BlueCross BlueShield. “These awards complement our existing grants and sponsorships with agencies that work to improve community health, in upstate New York.”

Excellus BlueCross BlueShield divides its 31-county Upstate New York operating area into four regions: the Rochester region, encompassing Livingston, Monroe, Ontario, Seneca, Wayne and Yates counties; the Central New York region, which includes Cayuga, Cortland, Onondaga, Oswego and Tompkins counties; the Southern Tier region, including Broome, Chemung, Chenango, Tioga, Schuyler and Steuben counties; and the Utica region, comprising Clinton, Delaware, Essex, Franklin, Fulton, Hamilton, Herkimer, Jefferson, Lewis, Madison, Montgomery, Oneida, Otsego and St. Lawrence counties.

The application can be found at news.excellusbcbs.com/news-room/community-investments-partnerships.

[email protected] / 585-653-4021
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Excellus BCBS, healthcare providers to offer nurse telehealth visits for new parents

Excellus BlueCross BlueShield is partnering with several health organizations to offer families support in caring for a newborn.

ROC Family Connects will provide parents of newborns free telehealth visits with a registered nurse from the child’s primary care practice for the first six months of a baby’s life as a support to families in addition to their usual newborn scheduled office visits.

The service will be available for many Excellus BCBS members.

“ROC Family Connects does just that it connects parents and infants with resources to promote the child’s and family’s healthy development,” said Brian Steele, vice president of medical affairs, clinical services for Excellus BCBS. “These visits are designed to provide guidance and support to parents and connect families to community services based on individual needs and preferences.”

The nurse will provide a health check for the baby, make sure the mother is recovering after childbirth and offer information on routine infant care and child development. The nurse also will screen family-specific needs in areas of health care, breastfeeding, parenting and other issues.

Families will be enrolled at prenatal care appointments or through the baby’s primary care practice when the child is born. Most families will receive an initial visit, with up to three follow-up visits in the first six months of the baby’s life.

ROC Family Connects is a supported adaptation of the Family Connects International program, a program of Duke University’s Center for Child and Family Policy.

The local program is available through Excellus BCBS’ partnerships with Accountable Health Partners, Greater Rochester Independent Practice Association, Rochester Regional Health, Jordan Health and the University of Rochester Medical Center. The United Way of Greater Rochester Inc., the Children’s Agenda and Children’s Institute helped start the program.

“Adjusting to a newborn is difficult enough, but during a pandemic, families are distanced from friends and family who otherwise would have provided help and guidance,” said United Way’s Chief Impact Officer Jennifer Cathy. “Thank you to Excellus BlueCross BlueShield, ESL Federal Credit Union and Konar Foundation for recognizing the importance of partnering to support moms, dads and babies. We look forward to seeing the positive outcomes of this unique program and health care partnership on families throughout our community.”

[email protected] / 585-653-4021
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Excellus plans $17.6 million premium refunds

Excellus BlueCross BlueShield will issue $17.6 million in medical premium refund credits to roughly 700 large group employer and union-sponsored plans that are prospectively rated as part of its comprehensive community response to the COVID-19 pandemic.

Last month, the health insurer issued $3.4 million in premium refund credits to employer groups who offered the plan’s dental coverage.

Christopher Booth, president of Excellus BlueCross BlueShield
Christopher Booth

“Keeping health care affordable is our mission as a non-profit insurer and it starts with not collecting more than we need to pay claims and run the business,” said Excellus CEO Christopher Booth. “When Upstate New York went into lockdown and elective medical care decreased, our claims payments also declined. We are returning a portion of the premium.”

The medical premium credit will appear on the bills being sent out in November, while the dental refund was credited on the groups’ October invoice.

To date, the health plan has spent or expects to spend more than $300 million this year as a result of the COVID-19 pandemic. That has taken the form of COVID-19 related claims and expanded coverage during the state of emergency, reductions in the administrative burden for health care providers, distribution of personal protective equipment for employers and providers and contributions to food banks and food pantries throughout the health plan’s upstate service territory, company officials said.

“Our priority continues to be taking care of the customer and making sure members have access to the care they need,” Booth said. “Our claim volumes have returned to normal levels given the demand for elective procedures and routine care that may have been put off during the quarantine. We are also still bracing for a possible second wave in COVID-19 related costs. We hope it doesn’t come but we are prepared if it does.”

[email protected] / 585-653-4021
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Excellus BCBS CEO to retire; successor named

Excellus BlueCross BlueShield and Lifetime Healthcare Cos. Inc. President and CEO Christopher Booth plans to retire on May 1, 2021. He will be succeeded by James Reed. the announcement is part of a planned succession for executive leadership of the $6 billion nonprofit health plan.

Christopher Booth
Christopher Booth

“In addition to his knowledge and talent, Chris’ commitment to building a strong corporate culture and having an engaged workforce has led to measurable improvements in business performance,” said Chairwoman Marianne Gaige. “The system of Lifetime Way values and the seven-block strategy focusing on operational excellence and stakeholder satisfaction are a testament to Chris’ vision and will serve this organization well for years to come.”

Booth has led Excellus BCBS since January 2013.

“When I took this job, I said it was an honor to lead such a talented workforce of people who provide care and coverage for their neighbors,” Booth said. “I’m incredibly proud of all of our employees, our senior leadership team and the remarkable corporate culture we have built together. That culture is built on collaboration, cooperation and communication. It is what’s helped us navigate successfully through a multi-year transformation of our claims systems, the implementation of the Affordable Care Act and the launch of innovative partnerships with local health care providers.”

Jim Reed
Jim Reed

Reed joined the organization in January 1996 and most recently served as executive vice president of marketing and sales, and as regional president in the Central New York market. He was responsible for line of business oversight and all marketing and sales functions for the commercial group markets, retail markets, Univera Healthcare and Lifetime Benefit Solutions. He also had oversight of the Health Care and Network Management division.

“Jim brings more than two decades of successful leadership within the organization to his new role and has been instrumental in helping shape the future of the company in today’s fast-changing and dynamic health insurance industry,” Gaige said. “Success starts with having the right people in the right roles. Jim is strategic in his approach, has a strong sense of mission and brings a wide array of experience to the job.”

Over the course of his career, Reed has been involved in the community through various nonprofit organizations. Reed serves on the board of directors for Centerstate CEO, the Greater Rochester Chamber of Commerce and HealtheConnections.

“Our focus remains on our organization’s primary mission of providing access to affordable, high-quality health care to as many people as possible,” Reed said. “As a locally based health plan, we have strong partnerships with those who provide care and those who pay for it and we want to build on that going forward.”

[email protected] / 585-653-4021
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Excellus BCBS expects to spend $162 million on COVID-19 response

Excellus BlueCross BlueShield expects to spend at least $162 million on its response to the COVID-19 pandemic, the organization said this week.

The health plan is directing more than $1 million in grants for testing supplies and personal protective equipment to Upstate New York hospitals and area health care workers. The company also is working with regional business groups to help employers and their employees return to work.

Christopher Booth, president of Excellus BlueCross BlueShield
Christopher Booth, president of Excellus BlueCross BlueShield

“No one has faced a public health crisis like COVID-19 in the almost 90 years that our health plan has provided coverage in Upstate New York,” said Excellus President and CEO Christopher Booth. “This crisis requires a strong and comprehensive response to assure our members are able to receive the care they need and to help assure the system will survive. The pandemic significantly impacted the economy, sickened tens of thousands of people and continues to threaten upstate health care.”

During the crisis, Excellus expanded access to telehealth, trained physician offices on how to use it and increased reimbursement to providers for those services. Officials said that allowed many local provider practices to continue to see patients using remote technology and replace lost in-office revenue.

The expanded coverage and increased reimbursement associate will cost at least $80 million in 2020, officials noted.

Excellus will absorb a $12 million reduction in Medicaid rates from New York State this year, rather than pass it on to providers. Restoring some Medicare fees for providers that had been cut at the federal level added $6 million in costs this year.

The health plan also took several steps to reduce the administrative burden on hospitals, which increased costs for the plan. That included suspension of prior-authorization reviews, clinical editing programs and claim filing requirements that will cost $51 million, as well as implementing the 20 percent increase in reimbursements for COVID-19 admissions required under new federal law, costing $3 million.

For members, Excellus absorbed the cost of member out-of-pocket expenses for the diagnosis and treatment of COVID-19, medically appropriate testing and the member cost-share for all telehealth visits. Those steps, the organization said, are adding roughly $9 million in costs this year.

The $162 million in unbudgeted spending is being funded through Excellus’ reserves, officials said, noting that the response is in addition to $192 million in cash advances the health plan had extended to most of the 70 upstate hospitals in its network prior to the pandemic.

“Our priority in this crisis continues to be taking care of the customer and making sure members have access to the care they been,” Booth said. “We are starting to see an increase in claims from the pent-up demand for elective procedures and routine care that may have been put off during the quarantine. We are also still bracing for a possible second wave in COVID-19 related costs later this year. We hope it doesn’t come. We must be prepared if it does and we are ready.”

[email protected] / 585-653-4021
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