How Blue Shield of California Is Rethinking Care Delivery with Susan Mullaney
Becker’s Healthcare PodcastSummary
Healthcare leaders face significant challenges as chronic diseases rise and costs escalate, prompting a shift from traditional fee-for-service models to more integrated care approaches. Susan Mullaney, Chief Operating Officer at Blue Shield of California, emphasizes the need for health plans and healthcare systems to collaborate closely, aligning financial incentives to improve health outcomes. With nearly half of Americans projected to have multiple chronic conditions by 2024, Mullaney advocates for a holistic model that prioritizes proactive care and data sharing among providers.
Blue Shield is pioneering innovative strategies to tackle these issues, including real-time prior authorization capabilities and partnerships with technology firms like Google and Salesforce to streamline processes. Mullaney highlights the success of their PriceCheck MyRx initiative, which helps members find the most cost-effective medications, resulting in significant savings. Additionally, the organization is disrupting the opaque pharmacy benefit manager model by launching a transparent, modular program aimed at providing affordable access to high-quality medications.
Looking ahead, Mullaney stresses the importance of integrating pharmaceutical care into overall healthcare strategies, particularly as new biotechnology innovations emerge. By focusing on creating seamless experiences for patients and fostering trust-based partnerships, Blue Shield aims to enhance care delivery and manage costs effectively in an increasingly complex healthcare landscape.
Show Notes
In this episode, Susan Mullaney, Chief Operating Officer at Blue Shield of California, discusses how stronger payer-provider partnerships, AI, value-based care, and pharmacy innovation can improve health outcomes, lower costs, and reshape care delivery for the future.
More from Becker’s Healthcare Podcast
In this episode, Dr. Daniel Sun, Orthopedic Surgeon at Tufts Medical Center, discusses advances in hip replacement, implant longevity, robotics and AI, and the growing shift toward outpatient procedures. He also explores balancing faster recovery and cost savings with patient safety and complication prevention.
In this episode, Tieraona Low Dog, MD, ABOIM, Founding Director of the Integrative and Functional Medicine Fellowship and pioneer in integrative medicine, and Shaista Malik, MD, PhD, MPH, Executive Director of the Susan Samueli Integrative Health Institute and Vice President of Integrative Health at UCI Health, join the podcast to discuss acupuncture and the integration of integrative and functional medicine into patient care. They also share insights on addressing skepticism, fostering an open-minded approach to healthcare, and the leadership principles that guide the fellowship.
This episode recorded live at the Becker's 11th Annual Health IT + Digital Health + RCM Conference features Marola Kraczek, MA, Senior Change Enablement Specialist, HCA Healthcare, who discusses the role of change management in turning healthcare data into actionable insights, reducing workflow fragmentation and supporting clinician adoption.
In this episode, Phoebe L. Yang. a former C-suite executive across four public companies, an appointee in two Presidential Administrations, and a Fortune 250/S&P 500 board director (GE HealthCare, Doximity, CommonSpirit Health, JudiHealth), most recently General Manager of Amazon Web Services Healthcare, and faculty of Stanford Law School, where she designed and teaches a popular course, "Business Leadership in the Age of AI”, discusses AI governance, cybersecurity, and responsible AI adoption. The views and opinions expressed by Phoebe Yang in this program are her own at the time of the recording of this podcast and do not necessarily reflect the views or positions of any organization with which she may be affiliated
In this episode, Jason Hinkle, CFO, Deaconess Illinois, discusses the system’s rapid growth, expansion of oncology and outpatient surgery services, and financial pressures facing rural hospitals. He also shares how rolling forecasts, enterprise wide data governance, and reliable data can strengthen financial decision making and prepare health systems for broader AI adoption.