The Blue Cross Blue Shield of Massachusetts Scenario Planning Process Paper Example

Introduction

The Blue Cross Blue Shield of Massachusetts is a health insurance organization which works under the Blue Cross Blue Shield Association. The company was formed in 1988 when two organizations, Blue Cross and Blue Shield, merged. The headquarters are at Boston, Massachusetts. Currently, the company provides insurance over 2.8 million policyholders most of which are insured through their employers. However, BCBSMA has a non-profit status with approximately 3,600 employees, and as of 2015, the total revenue of the insurance company was at $6.8 billion. After knowing the history of this health insurance company, it will be easy for me to engage with one of the leaders and ask questions regarding the firm. The primary goal of this essay is to formulate a scenario planning process by creating a set of questions that will be asked to one of the leaders in The Blue Cross Blue Shield of Massachusetts.

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The CEO BCBSMA, Andrew Dreyfus, is the leader I interviewed. The primary reason why I chose him is due to his broad knowledge regarding health insurance. Before the interview, I did a lot of research regarding the people in various ranks in the BCBSMA firm, and Dreyfus' educational background and work experience impressed me the most. For instance, the CEO previously served as the vice president of the Massachusetts Hospital Association. He also worked in the Massachusetts state government with a senior position in undersecretary of consumer affairs and business regulation. Before he was named the CEO in 2010, Dreyfus was the executive vice president of healthcare services at BCBSMA. In that position of the vice president, he led the campaign in the improvement of quality and safety of healthcare in the state. Other key players that I would interview include the Chief Financial Officer and Chief Operations Officer.

I drafted eight questions regarding the BCBSMA organization to ask the CEO. The list of questions and answers will be discussed below. What payment plan does the organization use to offer healthcare providers?

The CEO explained that the firm uses the alternative quality contract as its payment model. The plan was initiated by the former CEO of the organization in 2007 with the aim of preventing the wasteful spending of financial resources which led to the harm of patients (Barry, Stuart, Donohue, Greenfield, Kouri, Duckworth, & Huskamp, 2015). The AQC's are also modeled to ensure provider accountability. Under the initiatives, groups of doctors and other medical practitioners are paid to work as a team in providing healthcare services.

What partnerships does the company have?

Since BCBSMA is aimed at being an effective corporate citizen, the organization partners with other firms to promote better eating habits and lifestyles among the citizens (Swain, Daniels, & Allen, 2004). For instance, in 2017, the company made a $6 million contribution to non-profit organizations throughout Massachusetts, and the Blue Cross employees donated $400K.

What is the Blue Cross Blue Shield Massachusetts foundation and what is its function?

The BCBSMA foundation is an initiative aimed at expanding healthcare to the vulnerable people in the society in the Commonwealth especially those with low income. The foundation collaborates with other private firms to expand health coverage and eliminate barriers of healthcare through giving of grants and policy initiatives (Berwick, Calkins, McCannon, & Hackbarth, 2006).

What is your most significant achievement as the CEO?

Dreyfus explained that he was a part of the formation of the BCBSMA alternative quality contract which later became one of the most significant payment reforms initiatives in Massachusetts. Moreover, after being appointed as the CEO of the firm, he led the organization's collaborative efforts to improve the quality of healthcare in that state.

What is your take on the opioid epidemic?

Andrew Dreyfus explained that the opioid epidemic is a severe problem facing the state of Massachusetts. One of the leading causes of the outbreak is the issuance of legally prescribed drugs which are very easy to get in this state. The local communities also feel vulnerable. Since there are many contributing factors, Dreyfus explained that the epidemic has no specific solution. However, he said that all citizens must come up with innovative ways to address the issue and ensure that those affected receive proper medical care.

How do you plan to achieve the goals of healthcare reforms?

The CEO explained that reducing the number of uninsured people does not lead to the achievement of the healthcare reform goals. Instead, new strategies should be formulated to improve healthcare for Massachusetts' residents while reducing the costs for the same. He also explained that two years after the formulation of the reform, there was a system that offered coverage for all residents regardless of the employment status, income, age, or medical history (Long, Skopec, Shelto, Nordahl, & Walsh, 2016). Approximately 96% of Massachusetts' residents had health insurance, and since then, the company works to maintain that coverage level.

What are funding opportunities available?

The most significant funding opportunities are the Healthy Living Community Grants and the Programmatic and Sponsorship Requests.

How do members of BCBSMA get access to their health plan and other personal information?

Dreyfus explained that there is an app where members are required to key in their login details and passwords. With the app, citizens can view their Health Financial Information.

Driving Forces Observed in the Subject Matter

One of the driving forces of the CEO that I saw while interviewing him is confidence. As he talked, he seemed to be sure of his decisions that he had made for the benefit of the residents of Massachusetts. He was also very assertive a quality that has made him gain respect from his subordinates while in office. Secondly, Dreyfus is an excellent communicator. As I interviewed him, he did not interrupt me, and he seemed very keen. When responding to the questions, he was confident and fluent thus making the session lively and engaging. He explained the mission and vision of the company and his words motivated me. Every good leader must be an excellent communicator since the trait is required when you need to tell your subordinates about the strategies required to achieve the goals that have been set (Northouse, 2018). Like a good leader, Dreyfus is passionate and committed to providing better access to healthcare to all residents of Massachusetts. He explained that the employees are also very motivated since they follow his footsteps (Bolman & Deal, 2017).

Environmental Influences That Will Have an Impact on BCBSMA In the Future

One of the environmental influences identified by the CEO that will have an impact on the company in the coming years is technology since it can change the business environment drastically. It is critical for the insurance firm to adapt to technology since it is essential in research and development (Dowell & Muthulingam, 2017). With advanced technology, the firm will engage in creative and innovative techniques that will make operations easier in the long-term. Secondly, organizational culture is another driving force which is an essential factor since it is a combination of the current and past leaders, founders, and the history (Sarooghi, Libaers, & Burkemper, 2015). BCBSMA must aim at establishing its rituals and routines so that everyone becomes aware of what is expected of them. Sociological factors are also essential since they assist in the comprehension of the demographic cultures of the citizens wishing to be insured.

Conclusion

In conclusion, the scenario planning process was successful as I got to interview the CEO of the Blue Cross Blue Shield of Massachusetts which is a non-profit organization aimed at providing health insurance to all the residents of that state. I had eight interview questions that the CEO comprehensively answered regarding various issues associated with the insurance company. Some of the driving forces I observed as I interviewed the CEO were good communication skills, confidence, and passion. The environmental factors that he explained that may affect the firm in 5-10 years include technology, sociological factors, and the organization's culture.

References

Barry, C. L., Stuart, E. A., Donohue, J. M., Greenfield, S. F., Kouri, E., Duckworth, K., ... & Huskamp, H. A. (2015). The early impact of the 'Alternative Quality Contract'on mental health service use and spending in Massachusetts. Health Affairs, 34(12), 2077-2085.

Berwick, D. M., Calkins, D. R., McCannon, C. J., & Hackbarth, A. D. (2006). The 100 000 lives campaign: setting a goal and a deadline for improving health care quality. Jama, 295(3), 324-327.

Bolman, L. G., & Deal, T. E. (2017). Reframing organizations: Artistry, choice, and leadership. John Wiley & Sons.

Dowell, G. W., & Muthulingam, S. (2017). Will firms go green if it pays? T he impact of disruption, cost, and external factors on the adoption of environmental initiatives. Strategic Management Journal, 38(6), 1287-1304.

Long, S. K., Skopec, L., Shelto, A., Nordahl, K., & Walsh, K. K. (2016). Massachusetts health reform at ten years: great progress, but coverage gaps remain. Health Affairs, 35(9), 1633-1637.

Northouse, P. G. (2018). Leadership: Theory and practice. Sage publications.

Sarooghi, H., Libaers, D., & Burkemper, A. (2015). Examining the relationship between creativity and innovation: A meta-analysis of organizational, cultural, and environmental factors. Journal of business venturing, 30(5), 714-731.

Swain, S. E., Daniels, C. L., & Allen, J. S. (2004). The health care of homeless persons: a manual of communicable diseases & common problems in shelters & on the streets. Homeless.