For BlueCross BlueShield of Minnesota’s CIO Melissa Flicek, the need to improve the experience of the company’s members is personal. She was in the hospital for 21 days due to a benign brain tumor and struggled to understand why she couldn’t leave or what she needed to do to recover. “Navigating the healthcare system is complex,”she said recently. “If patients aren’t advocating for themselves, they can easily get lost. We need to come together as a healthcare community to provide better guidance.” This experience helped guide her as a technology executive who could do something about this.
BlueCross BlueShiel of Minnesota is the state’s oldest health plan provider, generating over $15 billion in annual revenue while serving diverse populations through employer-paid insurance, Medicare and Medicaid programs. Flicek has been the company’s Chief Information Officer for roughly a year. With a background that includes senior leadership roles at Optum, where she served as Chief Technology Officer and SVP of Consumer Technology and Experiences, Flicek has brought a customer-centric approach to BlueCross BlueShield of Minnesota’s technology strategy. She has focused on modernizing the company’s digital infrastructure, strengthening its data strategy and implementing advanced artificial intelligence solutions to enhance efficiency and patient care.
Laying a Modern Foundation for a Nearly 100-Year-Old Company
With BlueCross BlueShield of Minnesota’s long history comes the challenge of modernizing legacy systems to create a seamless member experience. “This role is about putting the member at the center of everything,” Flicek explained. “A key focus has been ensuring our foundation is ready to deliver the right member and patient experience.”
A crucial element of this transformation has been data consistency and accessibility. BlueCross BlueShield of Minnesota has streamlined its data architecture by reducing redundant copies and ensuring data accuracy across various touchpoints, from self-service tools like BlueCare Advisor to call centers and broker interactions. “The experience starts with data,” she noted. “It must be accurate and consistent across every interaction.”
Enhancing the Patient Experience with Data-Driven Insights
One of Flicek’s primary goals is optimizing BlueCross BlueShield of Minnesota’s data strategy to provide a unified and personalized patient experience. “Companies across industries strive for a single view of their customer,” she said. “We had multiple data warehouses and ways of accessing information, leading to inconsistencies.”
By transitioning to a single-copy architecture, BlueCross BlueShield of Minnesota reduced inaccuracies, eliminating duplicate data and optimizing its systems for better efficiency. This transformation allows the company to provide a more reliable and real-time understanding of patient needs, ensuring that the right data is available when needed. “When a member engages with us, whether online, through customer service or via a provider, we want to serve up the right answers faster,” Flicek underscored.
Leveraging AI to Improve Speed and Decision-Making
BlueCross BlueShield of Minnesota has embraced AI and machine learning to enhance efficiency and streamline patient interactions. “AI is a broad concept. It spans from machine learning to predictive modeling to generative AI,” Flicek explained. “We operate across that spectrum, ensuring we use AI where it provides real value.”
One example is predictive modeling, which helps employers manage rising healthcare costs. “We developed a proof-of-concept tool that, in just four weeks, provided predictive insights into healthcare costs per member per month,” she highlighted. “By analyzing trend data, we can help employers proactively identify cost drivers and potential interventions, including social determinants of health like food insecurity and social isolation.”
Another AI-powered initiative, Blue Ride, ensures that members who struggle with transportation can get to and from their appointments more reliably. Flicek emphasized that AI governance is critical in these applications. “AI should help our members get to a faster ‘yes’ in their healthcare journey,” she said. “However, if a decision needs to be made by a pharmacist, physician or nurse, a human will always be in the loop.”
The Advantages of a Non-Profit Model
Flicek, who previously worked in for-profit healthcare organizations, has found BlueCross BlueShield of Minnesota’s non-profit structure to be an advantage. “At for-profits, we focused on how to help the patient while maintaining profitability,” she said. “Here, it’s about ensuring we can meet the costs of delivering care sustainably. Transparency is key in this balance.”
Collaborating Across the BlueCross BlueShield Network
BlueCross BlueShield of Minnesota benefits from being part of a larger national network of BlueCross BlueShield organizations. “We have a CIO Forum where we share insights, discuss challenges and learn from each other,” Flicek explained. “For example, when refining our data strategy, I turned to my peers in other states who had undergone similar transformations. Their guidance was invaluable.”
This collaboration also extends to Medicare offerings, allowing BCBS plans to leverage national data and enhance their services. “Each state has different regulations and guidance, but by working together, we can align strategies and improve healthcare outcomes nationwide,” she said.
Looking Ahead: AI, Natural Language Processing and Predictive Analytics
As BlueCross BlueShield of Minnesota continues its transformation, Flicek is closely watching advancements in AI and natural language processing. “If we can make machines interact more like humans, we can enhance efficiency and improve patient interactions,” she said. However, she cautioned against adopting technology for technology’s sake. “The goal is to solve business problems, not just implement new tech. AI can’t replace human oversight. It needs to be governed and validated.”
Ultimately, Flicek remains focused on using technology to make healthcare more accessible, efficient and patient-centered. “Every day, we work to reduce the cost of care while improving the patient experience,” she said. “It’s about pushing forward, making things faster and easier and ensuring that when members reach out, we can provide them with the answers and support they need.” Her mission continues.
Peter High is President of Metis Strategy, a business and IT advisory firm. He has written three bestselling books, including his latest Getting to Nimble. He also moderates the Technovation podcast series and speaks at conferences around the world. Follow him on Twitter @PeterAHigh.
