Prudence Kuai
SVP and Chief Information Officer, Florida Blue
May 14, 2014
iHT² Payer-Provider Evolving
Business Models Su...
Florida Blue is an Independent Licensee of the Blue Cross and Blue Shield Association.
AGENDA
• Dynamics in the Health Car...
Florida Blue is an Independent Licensee of the Blue Cross and Blue Shield Association.
AGENDA
• Dynamics in the Health Car...
Florida Blue is an Independent Licensee of the Blue Cross and Blue Shield Association.
How Health Care is Changing…
4
Florida Blue is an Independent Licensee of the Blue Cross and Blue Shield Association.
Premium
Subsidies
Age
Rating
Compre...
Florida Blue is an Independent Licensee of the Blue Cross and Blue Shield Association.
AGENDA
• Dynamics in the Health Car...
Florida Blue is an Independent Licensee of the Blue Cross and Blue Shield Association. 7
• Florida Blue and its family of ...
Florida Blue is an Independent Licensee of the Blue Cross and Blue Shield Association.
Vision
A leading innovator enabling...
Florida Blue is an Independent Licensee of the Blue Cross and Blue Shield Association.
Riverside YMCA Florida Blue
Fitness...
Florida Blue is an Independent Licensee of the Blue Cross and Blue Shield Association.
Health Insurance EVOLUTION
to Healt...
Retail Centers
Community Health
& Wellness
Sales &
Retention
Member
Services
Education
& Events
Care Navigation
& Support
...
Florida Blue is an Independent Licensee of the Blue Cross and Blue Shield Association.
Innovations drive member
engagement...
Florida Blue is an Independent Licensee of the Blue Cross and Blue Shield Association. 13
Habit Heroes
14
Our delivery system is becoming a
mosaic of value models
Patient Centered Medical Homes (PCMH)
Bundled Payment Pilots
S...
Florida Blue is an Independent Licensee of the Blue Cross and Blue Shield Association.
Partnerships
15
Florida Blue is an Independent Licensee of the Blue Cross and Blue Shield Association.
Agenda
• Dynamics in the Health Car...
Florida Blue is an Independent Licensee of the Blue Cross and Blue Shield Association.
Future health plan role in
informat...
Florida Blue is an Independent Licensee of the Blue Cross and Blue Shield Association.
The Age of Consumer - Centric
Digit...
Florida Blue is an Independent Licensee of the Blue Cross and Blue Shield Association.
Multi - Channel Physician
Collabora...
Florida Blue is an Independent Licensee of the Blue Cross and Blue Shield Association.
Elements of Success for
ACO Partner...
Florida Blue is an Independent Licensee of the Blue Cross and Blue Shield Association.
Web - Mobile - Di gital
Health Care...
Florida Blue is an Independent Licensee of the Blue Cross and Blue Shield Association.
Information Life Cycle
Data Informa...
Florida Blue is an Independent Licensee of the Blue Cross and Blue Shield Association.
Key Messages
Technology leaders nee...
Upcoming SlideShare
Loading in …5
×

Payer-Provider Summit Boston 2014 Opening Keynote “The Power of Data” with Prudence Kuai, SVP, Chief Information Officer

497 views

Published on

Payer-Provider Summit Boston 2014 Opening Keynote “The Power of Data” with Prudence Kuai, SVP, Chief Information Officer

0 Comments
0 Likes
Statistics
Notes
  • Be the first to comment

  • Be the first to like this

No Downloads
Views
Total views
497
On SlideShare
0
From Embeds
0
Number of Embeds
2
Actions
Shares
0
Downloads
11
Comments
0
Likes
0
Embeds 0
No embeds

No notes for slide

Payer-Provider Summit Boston 2014 Opening Keynote “The Power of Data” with Prudence Kuai, SVP, Chief Information Officer

  1. 1. Prudence Kuai SVP and Chief Information Officer, Florida Blue May 14, 2014 iHT² Payer-Provider Evolving Business Models Summit: The Power of Data 1
  2. 2. Florida Blue is an Independent Licensee of the Blue Cross and Blue Shield Association. AGENDA • Dynamics in the Health Care and Health Insurance Industry • Florida Blue’s Positioning in the Marketplace • The Power of Data in Driving Industry Transformation 2
  3. 3. Florida Blue is an Independent Licensee of the Blue Cross and Blue Shield Association. AGENDA • Dynamics in the Health Care and Health Insurance Industry • Florida Blue’s Positioning in the Marketplace • The Power of Data in Driving Industry Transformation 3
  4. 4. Florida Blue is an Independent Licensee of the Blue Cross and Blue Shield Association. How Health Care is Changing… 4
  5. 5. Florida Blue is an Independent Licensee of the Blue Cross and Blue Shield Association. Premium Subsidies Age Rating Compression Health Insurance Tax Essential Benefit Changes Cost-sharing Subsidies New Market Rules 3Rs Competition Managing Through Change 5
  6. 6. Florida Blue is an Independent Licensee of the Blue Cross and Blue Shield Association. AGENDA • Dynamics in the Health Care and Health Insurance Industry • Florida Blue’s Positioning in the Marketplace • The Power of Data in Driving Industry Transformation 6
  7. 7. Florida Blue is an Independent Licensee of the Blue Cross and Blue Shield Association. 7 • Florida Blue and its family of subsidiaries serve more than 15 million people across the United States • 30% market share in Florida • Customer retention levels averaging 90 % • 25 Consecutive Years of Positive Net Income • $10 billion of revenue • Over $4 billion of GAP equity • AM Best rating upgraded to an “A+” • A+ Rating from Standard & Poor's Florida Blue – Who we are
  8. 8. Florida Blue is an Independent Licensee of the Blue Cross and Blue Shield Association. Vision A leading innovator enabling healthy communities Mission To help people and communities achieve better health Values Respect, Integrity, Imagination, Courage, Excellence 8 Our Mission, Vision & Values
  9. 9. Florida Blue is an Independent Licensee of the Blue Cross and Blue Shield Association. Riverside YMCA Florida Blue Fitness Center Tampa Bay Day of Caring Community Gardens Miami Rescue Mission 9 Building Strong Communities
  10. 10. Florida Blue is an Independent Licensee of the Blue Cross and Blue Shield Association. Health Insurance EVOLUTION to Health Solutions 10
  11. 11. Retail Centers Community Health & Wellness Sales & Retention Member Services Education & Events Care Navigation & Support 11
  12. 12. Florida Blue is an Independent Licensee of the Blue Cross and Blue Shield Association. Innovations drive member engagement/support Care Consulting Navigation Mobile Web Applications Better You From BlueSM Worksite Wellness Worksite Clinics HCR e-Book 12
  13. 13. Florida Blue is an Independent Licensee of the Blue Cross and Blue Shield Association. 13 Habit Heroes
  14. 14. 14 Our delivery system is becoming a mosaic of value models Patient Centered Medical Homes (PCMH) Bundled Payment Pilots Staff Model HMOs 2 1 Physician Groups 3 1 2 Medicare Collaborative Care Models ACO Models 3,5 2 1 7 4,6 8
  15. 15. Florida Blue is an Independent Licensee of the Blue Cross and Blue Shield Association. Partnerships 15
  16. 16. Florida Blue is an Independent Licensee of the Blue Cross and Blue Shield Association. Agenda • Dynamics in the Health Care and Health Insurance Industry • Florida Blue’s Positioning in the Marketplace • The Power of Data in Driving Industry Transformation 16
  17. 17. Florida Blue is an Independent Licensee of the Blue Cross and Blue Shield Association. Future health plan role in information exchange Encounters Engagement Clinical IncentivesCosts 17 Providers Members Partners Employers
  18. 18. Florida Blue is an Independent Licensee of the Blue Cross and Blue Shield Association. The Age of Consumer - Centric Digit al Healt h Health Consumer Early Disease Detection Personalized Treatment Plans Optimized Prevention Complete Health Record Real Time Biometrics 18
  19. 19. Florida Blue is an Independent Licensee of the Blue Cross and Blue Shield Association. Multi - Channel Physician Collaborat ion DataCollectionandAnalytics Digitization Genomics Biometric Devices 19 Web Mobile Physician Portal ER Platform
  20. 20. Florida Blue is an Independent Licensee of the Blue Cross and Blue Shield Association. Elements of Success for ACO Partners hip Trust between parties Shared savings that aligns incentives with the best interest of the member/patient Data Transparency All parties with a vested interest in success Quality being clearly defined and measurable 20
  21. 21. Florida Blue is an Independent Licensee of the Blue Cross and Blue Shield Association. Web - Mobile - Di gital Health Care Reform eBook Member Website Mobile EMR 21
  22. 22. Florida Blue is an Independent Licensee of the Blue Cross and Blue Shield Association. Information Life Cycle Data Information Knowledge Value Use/ Access ActionMeaning We must deliver an information ecosystem and structure that enable the value creation We must define the future information needs that will drive value QuestionsContextSource 22
  23. 23. Florida Blue is an Independent Licensee of the Blue Cross and Blue Shield Association. Key Messages Technology leaders need to: • Realize great opportunities and great responsibilities • Establish solid data and information management strategies and roadmap • Engage and collaborate with business leaders internally and externally • Exhibit leadership to execute the strategies 23

×