In 2018, the Spira Care story came to life. What started as a bold initiative to create a simplified healthcare experience for members—one that put them at the center of everything—became a reality as we opened the doors to the Shawnee and Olathe Spira Care Centers.

Based on our clients’ feedback, it’s fair to say the reaction has been positive.

“It’s the first time I’ve had employees excited about going to the doctor,” said Amy Willyard, Human Resources Director for Mortgage Lenders of America. “I’ve been doing HR for 25 years and I’ve never had employees come back and brag about our health plan.”

While this sort of response has helped validate our initial plans, we look to the data to tell us if our new approach to healthcare is working. And there’s good news on that front as well.

In Spira Care’s first year, we’ve seen substantial decreases in acute admissions and emergency room visits. We’ve seen an increase in primary care visits and a corresponding decrease in specialty care visits. In just one year, Spira Care has been able to deliver total cost of care savings. Although it’s preliminary, that’s real cost savings for clients and members.

“Our primary care visits are up, but we’ll happily make that tradeoff because it’s all about getting the right care delivered at the right time and the right place,” said Dave Olson, Blue KC Vice President of Business Development. “By investing in primary care, we’re able to give the member a better experience and reduce the total cost of care.”

A New Approach to Primary Care

One of the benefits of starting the Spira Care story from a blank page was that it enabled us to completely re-envision what the healthcare experience could look like. For starters, we combined primary care with health insurance to simplify the member experience, making it more personal and affordable.

We also integrated behavioral health consultations into our primary care offering. By bringing medical and behavioral health services together under one roof, chronic conditions like diabetes, asthma, obesity and cardiovascular disease can be managed more holistically to achieve better health outcomes and improve quality of life.

“We recognize that many chronic diseases have coexistent behavioral health components to them. By focusing on both components, we can make a real difference in people’s lives,” said Dr. Greg Sweat, Senior Vice President and Chief Medical Officer.

The Care Guide Difference

We know the healthcare landscape can be confusing. So, we asked ourselves what it would look like if members had someone in their corner, ready to do things like explain benefits, answer questions, help make appointments and find in-network specialists. With Spira Care, we’ve empowered people to do just these things. We call them Care Guides, and we think of them as a member’s healthcare partner.

Since Spira Care is a unique combination of both care and coverage under one roof, we have Care Guides that come from varied backgrounds. Some are registered nurses who can help members understand what type of visit is appropriate for their needs. Some have extensive backgrounds in health insurance and can provide expert help when explaining benefits and plan details. All of our Care Guides share a passion and enthusiasm for going above and beyond to help each and every member. It’s one of the many things that makes Spira Care unlike any other healthcare model.

The Story Continues

The momentum of the first year has positioned Spira Care to grow exponentially in the future. As Dr. Sweat said, “We will continue to evolve Spira Care to meet the needs of our members.”

In the second half of 2018, Spira Care expanded its footprint by building three more Care Centers. The Crossroads, Lee’s Summit and Liberty locations, which opened on January 2, 2019, represent the next chapter for Spira Care and allow us to tell this success story to members throughout the greater Kansas City area.

In 2018, Blue KC made changes to implement a more customer-centric corporate culture by forming a dedicated Customer Experience team, tasked with making customer loyalty the job of every department.

The Blue KC Customer Experience (CX) team has led the way in evolving the organization’s mindset to an “outside-in” approach—where the customer relationship drives goal-setting and decision-making.

CX is more than just a theory—it’s a proven business strategy. Companies that prioritize their customers’ experiences over internal objectives, like cutting costs or creating efficiencies, have consistently higher loyalty than companies that prioritize internal goals.

"We set our goals around what will create and maintain loyalty among our customers instead of trying to get customers to engage with Blue KC in a way that supports our corporate goals," said Gratia Carver, Department Vice President of Customer Experience.

This dramatic shift in priorities requires buy-in at every level. Carver emphasized, “We’ve been very fortunate to enjoy tremendous executive support as we’ve made this transition. We could not have achieved this kind of success without total commitment from our executive team.”

What is customer experience?

Customer Experience (CX) is the perception and feelings our customers have about their relationships, connections and touchpoints with Blue KC. To track and analyze these perceptions, our CX team developed the CX Measurement Portfolio, a customer survey that assesses the ease, effectiveness, trust and loyalty our customers feel in their interactions with Blue KC.

CX makes it easy

The CX team introduced Blue KC employees to an expanded definition of customer experience with unexpected “acts of easy,” small gestures that went a long way toward making difficult situations better. From offering golf cart rides to employees who had a long walk to their car to passing out umbrellas and ice scrapers during inclement weather, the CX team looks for ways to surprise and delight employees.

Building CX into our company goals

Everyone at Blue KC impacts members in some way during the course of their journey. To successfully achieve the “outside-in” approach, improving customer experience is a key element in our 2019 strategy and part of our overall corporate incentive structure.

For many employers, Type 2 diabetes continues to be the top condition impacting benefit plan costs. According to the Centers for Disease Control and Prevention (CDC), approximately one in three Americans have prediabetes. Most of those don’t know they are on the verge of developing the disease, and without intervention, about half of them will be diagnosed with diabetes in the next five to 10 years.

To combat these staggering numbers, Blue KC launched a Diabetes Prevention Program, a new preventive care benefit available to eligible Blue KC members at no cost. By offering lifestyle changes that can lead to weight loss and healthier habits, this new program helps participants reduce their risk of developing Type 2 diabetes and focus on their general well-being.

“The program helps mitigate other health risk factors, like obesity and heart disease, in addition to diabetes,” said Noelle King-Whitlow, Department Vice President, Healthcare Transformation. “Our goal is to effectively pursue better overall health for our members while lowering healthcare costs for the community.”

The program starts with eligible members connecting with a partner who will guide them as they establish, pursue and track their health goals. What follows is typically a 16-week series of lessons and access to a lifestyle coach and support group, as well as helpful tools like wireless scales and fitness trackers.

Blue KC is offering a new remote monitoring program to keep at-risk members connected with healthcare professionals to detect potential health crises before they happen.

Launched in September, the program is now being utilized by nearly 300 participants. It’s designed to give members with congestive heart failure and/or diabetes the ability to monitor and share their daily vital signs—blood pressure, heart rate, weight, pulse, oxygen and blood sugar—with a registered nurse from the comfort of their own home. With access to their patients’ daily health data, providers can help prevent emergency room visits and hospitalizations.

“For members with certain conditions, small changes in health can signal big, even life-threatening issues. On top of that, these issues can deteriorate quickly, sometimes becoming critical in a matter of hours. With remote monitoring, we can see what’s going on with our members and help them get care before it gets to a critical stage,” said Raelene Knolla, D.O., Department Vice President and Senior Medical Director.

Participating members receive a home wellness kit with all the equipment they need—an internet connection isn’t even required. Participants also receive an app that provides personalized educational content, video conferencing and interactive health sessions with a clinician. Best of all, the program is offered at no cost to employers or members.

One member who recently joined the program quickly recognized the value. The education our nurses provided and the results of his remote monitoring helped him identify symptoms he had previously ignored. As a result, he immediately went to see his physician and circumvented what could have been a lengthy and expensive hospital stay.