Navigating the health care system is complicated. As president and CEO of Empire BlueCross BlueShield, Alan J. Murray has made it his mission to materially and measurably improve the health of all New Yorkers, and as part of that, his team works every day to simplify health care for Empire customers and members.
In June, Murray began leading a broader national team working to improve the health of diverse populations, such as students and the workforce, with purpose-built innovative health plans. Prior to joining Empire, he was the founding president and CEO of Northwell’s CareConnect Insurance Company Inc., the first provider-owned commercial insurance plan in New York State. He built the foundation of his career over a decade in leadership roles, including vice president, New York market leader at UnitedHealthcare and regional vice president, New York provider and ancillary network development at Empire.
Crain’s Content Studio recently spoke with Murray about Empire BlueCross BlueShield’s new programs, networks and innovations to improve the quality of care in the most efficient way possible.
CRAIN’S: How can employers and insurers reduce health care costs?
Alan J. Murray: Reducing health care costs starts with maintaining holistic health, which means considering all factors that influence health, including physical, behavioral and social factors. The healthier people are, the more time they can spend enjoying their lives. In addition, maintaining the overall health of employees can also increase productivity. According to the Centers for Disease Control and Prevention, healthier employees are more productive and less likely to call in sick or use sick leave. In order to achieve overall health, it is extremely important to have the right networks. They are the key that unlocks member benefits and gives them access to hospitals and providers.
CRAIN’S: What are the different Empire BlueCross BlueShield networks and how do they work?
Murray: At Empire, we’ve simplified our network strategy to offer three commercial networks, each with different benefits, so our customers and members can choose a network that suits their needs.
Connection is our most accessible network. It provides the largest premium savings while continuing to offer in-network access to most key hospital systems in Empire’s service area. Blue Access combines premium savings with extensive network coverage. PPO/EPO offers the broadest coverage in the network, with nearly 100% hospital participation in Empire’s service area. All providers in Connection are in Blue Access, and all providers in Connection and Blue Access are in PPO/EPO. In addition, all three networks give members access to the BlueCard network nationwide, an important feature for members who either live or travel outside Empire’s service area.
After one year, the Blue Access network, which ranks in the middle in terms of cost and coverage, accounts for 50% of new sales in the fully insured commercial segment. Blue Access introduces system-wide benefits: It helps providers because most of the benefits in this product are designed to keep patients in-network within a provider’s existing health management programs. It also benefits members by promoting better health outcomes and employers by offering savings.
CRAIN’S: What is the SydneySM Health app and how can members use it to maximize their benefits?
Murray: One of the most important tips for employers is to encourage their employees to download our Sydney Health app. Sydney is a free app that connects our members with instant access to their health insurance information. Think of it as the front door to taking care of yourself. Sydney gives members access to everything from their Member ID and claim information to a virtual provider visit and wellness programs. Sydney offers many different resources to support members who want to improve their overall health. The latest innovation available through Sydney is access to virtual primary care, which is one way we are working to close gaps in care.
CRAIN’S: What is virtual primary care? Why should employers care?
Murray: There is a nationwide shortage of primary care physicians, and many people do not have an existing relationship with a primary care provider. At the same time, studies show that people who have a relationship with a trusted primary care provider are more likely to be more satisfied with the health care system and less likely to need emergency room care or hospitalization in emergency hospital.