Podcast

Transforming the Payer Space: CTO Talk with Lee Green at BCBS Massachusetts


Matt Ferrari

by Matt Ferrari
Chief Technology Officer
ClearDATA


Sometimes when I’m hosting my podcast series CTO Talk on HealthcareNOW Radio, I end up with a guest where I really regret that these episodes are only 30 minutes long. This was one of those times as Lee Green, chief architect at Blue Cross Blue Shield Massachusetts joined me for a lively and informative conversation around cloud transformation in the payer space. While we could have gone another hour, we did manage to cover a lot of important ground in our time together and I think you’ll gain some useful insights in listening to what he has to say.

If you’re in healthcare, you may know there is a lot of transformation happening in the payer space, and a lot of that is led by architects like Lee, who is one of the best and brightest. Outside of healthcare, people often believe companies that drive the payer market only have an antiquated view as it relates to systems and architecture.  Lee’s charge is daunting: he’s tasked with modernizing the technology behind member and provider relations from legacy to cloud in order to meet today’s expectations from consumers and corporate partners.

As Lee points out in his comments, payers are moving from a history of using 15 to 20-year-old legacy infrastructure in a transactional way that operated largely in both data silos and business unit silos to one of collaboration with secure data in the cloud. People are working across business units to dive into analytics, gleaning meaningful insights they can use to drive improved engagement, health and satisfaction of their members.

When you are working through your annual enrollment selecting your health plan options, folks on Lee’s team are working, behind the scenes, across as many as 15 business units. As Lee points out so succinctly, “Silos are not going to work in the world of tomorrow.” He talks about the change management underway at BCBS Massachusetts to prepare for tomorrow, today.

I admire the way he and his organization are working to get into the mindset of their members and striving to continually evolve their UX and customer experience. He talks about how we live in an information-rich world where consumers are wanting their payers and providers to offer them the same kind of service their favorite shopping app does. Consumers are no longer accepting that they have to call their provider to gain any understanding of their plans – they want it fed to them via mobile apps and experiences that meet them where they are.

That means understanding the capabilities and use cases of new technologies as well as how this intersects with his own business objectives. Lee says “technology will not resolve broken business processes; it often actually accentuates them” which rang true to me. You can’t just rely on a piece of technology to solve a problem; you have to think about what your end goals are and make sure you’re doing all of the change management necessary to meet that end, and of course in the payer space, you have to it securely to protect patient privacy.

Lee expands on some of the challenges and new ways of thinking this brings as payers prepare to do business in a different way. For example, when Lee was forming his action plan for cloud transformation it wasn’t envisioned as a lift and shift migration. He had a lot of older existing technology that he had to think about. He’ll share how he prioritized his cloud transformation into three categories: Cloud Yes/Cloud First (these functions will always be on cloud) and Cloud Maybe to Cloud No for functions and features he’s keeping on prem - at least for now. This gave him a road map to approach this transformation strategically and to begin to quickly deliver BCBS Massachusetts members and provider partners with the kind of experiences and services they needed.  As he says in this podcast, “When I think about where I can use cloud, I don’t just think about all of the cost savings and flexibility and many other things all of us architects love, I am thinking about how we can use it as a transformational carrot (or stick) to move to the cloud in areas that are new and nimble and drive transformation in how we operate, how we staff and how we approach projects.”

I’m proud to be working with Lee and BSBS Massachusetts on this transformation and struck by how much they recognize that everything they are doing isn’t just about technology, it’s about improving experiences and health for their members.

Enjoy the conversation!