Q&A with Jenny Housley

Q: Blue KC has announced that it’s getting back into the ACA marketplace for the coming enrollment period. What has changed in the broader insurance market that makes this the right move?

A: Over the past couple of years, we have seen this market segment stabilize quite a bit and it looks to be sustainable, given the risk of the population insured today. We like that. And we feel like the pandemic, COVID, really increased the need for Blue KC to consider re-entering. We had been contemplating it, and every year we reassess, but felt this was the right year to re-enter, given what COVID has done in the Kansas City community.

Q: You’ve made some programming changes, as well, that made the decision easier, haven’t you?

A: We’ve really invested a lot in the development of innovative solutions we think will help us manage the health of this population better than when we were in the ACA previously. Some of those, like Spira Care, that solution is a big differentiator for us, and will provide some unique options for consumers this time around. Plus, virtual care is a much bigger play today than it was when we were in the ACA before, which allows us to provide greater access to more affordable care than traditional insurance plans.

Q: A lot of buzz in the insurance community this year with behavioral health issues, particularly in the wake of the COVID-19 lockdowns and work-from-home stresses. Where are you all in terms of addressing those challenges?
A: We recently launched our new behavioral health program, Mindful, and it’s available to every single member today. If you’re enrolled in a group insurance plan, you have access to Mindful, and on Jan. 1, it will be available to all consumers who purchase coverage through the ACA exchange.

Q: How is that type of coverage changing in its emphasis and execution?

A: The focuses on behavioral care are different today than they were three years ago. It’s a big investment for us across all our membership; we believe in it, and it’s not something we want people to pick and choose from a plan menu. It really goes to support our belief that if we help manage and support our members’ whole health—primary, specialty and behavioral—they will feel better, their outcomes will be better, and they will be better employees for Kansas City employers.

Q: You all aren’t alone with the move to ACA; we’ve seen a number of other large carriers announce intentions to re-engage with the Marketplace. Do you expect that increased competition will help with cost control for consumers?

A: We can’t speak to what everybody else is doing yet, but by late October, we’ll get better picture of what will be out there. With competitors, people have tried to duplicate parts of Spira Care, but no one has been able to create a comprehensive offering to include doctor-led care with on-site behavioral health support plus access to labs, x-rays and prescription drugs. We’re unique with that.

Q: What indications do you have that changes in care delivery like that will move the needle on population health?

A: We are seeing positive results. Jan. 1 of 2018, when we started Spira Care, we had about 4,000 members; in January 2019, we added another 25,000 all at once. Now we’re starting to see the data, and have a full year of data on almost 30,000 in population. It’s starting to get credible enough to do something with it and validate that it’s working. But we absolutely are seeing the number of ER admissions lower with this population, we’re seeing the impact on behavioral health. Are we seeing the impact on the total cost of care? The answer is yes.