What They’re Watching: Dan Richards, Regence BlueCross BlueShield

Dan Richards is the Manager of Sales at Regence BlueCross BlueShield of Utah. He joins us in this edition of “What They’re Watching” to discuss engaging consumers and creating seamless care for the patient.


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“The biggest aspect that we’re watching right now is how do we effectively engage the consumer? The best way that we’re going to manage the cost of health care, that we’re going to meet the needs of the Triple Aim — which is increasing the population health, decreasing the cost of health care, and creating a better experience — is to effectively engage the consumer. And that’s really been what has been difficult in years past. And so, Cambia is focusing on that (Regence BlueCross being a subsidiary of Cambia) in a number of ways.

One of which is value-based contracting. Changing from a fee-for-service basis — a basis that is incentivizing providers to do the wrong things, to do too much care, to do things that line their pockets –and switching over to a value-based contracting model where we’re able to align with a provider in a way that really they went to medical school to do. To get people healthier and to do so in a way that they can be compensated, but they can create a mechanism or an environment where the employee, the member, the utilizer of health care is doing the right things and receiving the right care at the right time. So, that’s really important to us.

And then creating tools that we’re able to use like at Project Seamless that I discussed in our forum. What Project Seamless is, is it’s a platform that allows individuals to access various mechanisms to support them in their care. One of those is a care guide. With a care guide that is both artificial intelligence-based plus a human interaction. That it’s both efficient as well as caring and nurturing, that has the ability to discuss a member’s needs anywhere from, “what is the cost of this procedure?” to “how do I get to the doctor?” to “I have a mental health issue can you engage a mental health professional?” all within a chat platform that we can bring out and do it via chat, email, or phone call. So again, meeting the member where they are, providing those tools that support them, and then engage them in a way that is both efficient but very powerful and very valuable.”