Inside Dana Erickson's First 10 Months as CEO of Blue Cross MN

"We do compete against the for-profit nationals and have proven we can win against them," says the executive, who applies her diverse background to advance affordability, provider collaboration, and health equity.

This article appears in the November/December 2022 edition of HealthLeaders magazine.

As Dana Erickson approaches her one-year mark as president and CEO of Blue Cross and Blue Shield of Minnesota (Blue Cross MN), she shared with HealthLeaders her vision for better healthcare in Minnesota and the just-minted strategy that is designed to deliver place, plan, and industry-based solutions against healthcare's most persistent problems.

"Was it always my goal? No, I don't think so."

Erickson wasn't gunning to be CEO, but a combination of service, experience, and opportunity—and positions with Optum Health—positioned her for the role.

"I think it was something that did emerge over time," says Erickson, who served in four prior roles with Blue Cross MN before taking the top position.

"What I love about the organization from my whole development perspective—there are many things that I love—was the ability to be involved in so many parts of the enterprise."

She adds: "Certainly [the CEO role] was a part of the conversations I had with leaders throughout my time. It's always that mix of opportunity and preparedness. By nature, I'm a curious person so I've always taken every opportunity I can to learn different parts of the healthcare system. I've worked on the provider side as a nurse, I've worked in public health and home care. All of that work prepared me for a role that brings all of those pieces together."

That background included progressive roles with Blue Cross MN since 2015, including director of Integrated Health Management, senior director then VP of Care Management, and SVP of Health Services.

A first look at the Blue Cross MN strategic plan

Continuity combined with new strategic initiatives are the language of a leader who has spent seven years with a not-for-profit plan—and another decade as a nurse, home health provider, and executive with Optum Health, the health services arm of for-profit UnitedHealth Group.

"I was on the executive leadership team [at Blue Cross MN] and was well aware and very involved with the strategic work that had been done to date," says Erickson. "There are several things in our new strategic plan that were already been in motion. Payment base rate, for example, was part of my prior role. That's certainly something that will continue along with affordability, customer experience, and health equity."

Blue Cross MN shared its new three-year strategic plan, which is focused on five interlocking areas that will advance short-term and long-term goals:

• Expanding overall market leadership with growth in all segments.
   
• Growing affordability initiatives to lower the cost of care, including optimization of clinical programs and increasing the level of at-risk claims going through VBC contracts within our provider network.
   
• Advocating for members at every step of their health journey and earning top rankings in industry benchmarks for customer experience.
   
• Paving the way for everyone to achieve their healthiest life by ensuring that company initiatives and priorities are developed, designed, and deployed through the lens of racial and health equity.
   
• Ensuring that the workforce will mirror the diverse membership, with a high-performing, inclusive environment that strengthens their position as a top place to work.

Detailing strategic objectives—starting with affordability

In her conversation with HealthLeaders, Erikson spoke often of affordability—the innovation that, for the most part, has eluded industry progress.

"We are fundamentally, unabashedly focused on affordability because that's what's keeping people from even entering the door," stresses Erickson. "I feel strongly that part of our work on the payer side is getting people access to care."

Erickson adds: "I know that we all love to talk about innovation and advancements, and we need to. But even with the most innovative solution, if it's not affordable, people won't have access to it."

Pictured: Dana Erickson, president and CEO, Blue Cross and Blue Shield of Minnesota.

Working shoulder to shoulder with providers

Erickson identifies to key targets to affordability—deeper, more strategic collaboration that Blue Cross MN calls its joint accountability model, which transcends contracting and financials.

"How do we not just financially collaborate with providers but also find other areas of commonality and strategic alignment that we can work on together. [Access to care and health equity] are a huge driver for me personally, and for the organization."

Erickson adds: "We can help providers be successful in those types of models, but they also have a responsibility and a role to play to be a part of the solution."

A new era of plan-provider collaboration

Perhaps more than ever before, health plans seem keen on provider collaboration. With news that prior authorization practices contribute to workforce burnout and shortages, payers are wise to treat providers as partners.

Noting pervasive and increasingly high-cost workforce challenges, Erickson adds: "We're at a point where we don't have enough clinicians to sustain the prior model. We have to move away from contractual relations and toward strategic partnerships—having like-minded providers that want to help us collectively address these systemic issues."

For Erickson, enhanced collaboration is personal.

"Collaborating with providers is a focus of mine. It's really driven out of my background of actually providing direct patient care and working in public health. Providers are a key part of the ecosystem, but they can't solve healthcare's issues alone."

Access to care: the first customer experience threshold

Innovation is irrelevant if you can't afford a health plan's gateway offering: coverage.

"I believe that part of our mission is getting people access to care," says Erickson. "So many people have a barrier to even accessing care and knowing where to go. The advocacy piece becomes critical."

Once people are in the door, a combination of customer experience, provider collaboration, and technology help create a loyal health plan member.

"A personalized approach to healthcare is an expectation that consumers have now," says Erickson. "Probably 10 years ago, it was about customization. Now it's about personalization. How do we how to make that experience personalized and specific to them to get the best outcomes possible?"

The CEO adds: "The use of technology has changed the expectation. Our ability to partner with providers on that type of care is critical. All of that has to be done within a payment model that supports that. Then ask, 'How can we provide better data and analytics? Where are we duplicating efforts and working against each other?'"

Erickson ends the topic with: "You have to really remember that the patient is the goal here."

Serving at ground zero

Even with the patient as the goal, not all patients facing life's storms are in the same kind of rowboat.

"It's something that motivates me on a daily basis," says Erickson. "I pull on the experiences I had as a home health nurse, of walking into people's homes and seeing that all of the equipment that we thought was going to change their life that was ordered in the doctor's office was sitting in the bathtub. And that happened on multiple occasions. Or refrigerators that were empty when I opened the door."

Flash forward to 2020. As the pandemic was emerging, Minneapolis was in the spotlight for a different kind of inequity—the treatment of black Americans by the police.

"We came out of ground zero for George Floyd's murder," Erickson makes it a point to discuss. "It was important for the whole community to come together out of that crisis."

That wasn't the last crisis. As The Independent wrote in April 2021:

"George Floyd and Daunte Wright never met but there's a chilling overlap between the two men. They died within 11 miles of each other. Mr. Floyd on the south side of Minneapolis and Mr. Wright in Brooklyn Center to the north of the city." Brooklyn Center, the "first-ring suburban city … in the Minneapolis-Saint Paul metropolitan area," became a priority response site for Blue Cross MN.

"We in the Twin Cities came out of ground zero for George Floyd's murder," says Erickson.

"It was important for the whole community to come together out of that crisis. Then there was another police-involved shooting, Daunte Wright. We then specifically had a call with city officials in Brooklyn Center and our leaders jointly determined a strategy that we call place-based initiatives."

Erickson adds: "Solutions come from communities. That's our belief. We need to listen to the community tell us what they need versus us coming in an applying what we think."

Those solutions include TurnSignl, a new app providing on-demand and real-time legal services to de-escalate encounters between motorists and law enforcement, as well as no-cost access to culturally responsive and trauma-informed teletherapy through Hurdle Health.

Regarding equity, Erickson ends with: "It is the right time for the healthcare system. Collectively it's about combining our efforts around a common pain point."