Blue Shield of California is expanding its Wellvolution digital health program to Medicaid members, the company said Monday.
Wellvolution has been available across California to commercial members since its launch in 2019. It allows members to enroll in various wellness digital health programs covering conditions such as mental health support and diabetes management.
The expansion to Medicaid members comes as Blue Shield of California’s participation in Medi-Cal, the nation’s largest Medicaid program, is in flux.
The California Department of Health Care Services implemented its first-ever competitive Medicaid bidding process for insurers last year and did not select Blue Shield of California. Blue Shield appealed the process in October and in December, the state agency changed course and awarded the insurer a contract to serve Medicaid beneficiaries in San Diego County for 2024.
A spokesperson for Blue Shield of California said the company’s Blue Shield Promise Medicaid plan has around 400,000 members in San Diego County and Los Angeles County, where it will continue to have a presence in 2024 through a subcontractor agreement with the publicly operated L.A. Care Health Plan. Blue Shield will use the digital health programs as a differentiator for people choosing Medicaid plans in San Diego and Los Angeles counties.
For Wellvolution, Blue Shield works with digital health companies including Headspace and Ginger on mental health, Betr Health for diabetes and chronic care management, EX Program for tobacco cessation, and others. These programs are offered at no additional costs.
“The concept of Wellvolution is that a member can self-serve,” said Angie Kalousek-Ebrahimi, senior director of lifestyle medicine at Blue Shield of California. “They go to the platform, answer a series of questions to receive guidance on what programs they qualify for and which ones might be most beneficial to them.”
More than 100,000 members have signed up for Wellvolution. The apps are offered through a platform developed by digital health company Solera Health, Kalousek-Ebrahimi said. Blue Shield pays digital health companies based on engagement and outcomes, she said.
“We will pay you if a member enrolls in your program, if they have deep engagement and then we’ll pay you a larger amount when they hit clinically significant outcomes," she said
As an example, members enrolled in Ginger’s mental health program are measured on an assessment tool used by behavioral health clinicians that assess someone's depression symptoms called the Patient Health Questionnaire-9. Other programs may include tracking weight loss through digital scales and use of Fitbit devices.
But it’s not just about improving outcomes. The digital health wellness program is also an attempt to lower overall costs for the health insurance company, Kalousek-Ebrahimi said.
“People who are taking care of themselves and addressing their conditions are generally healthier,” Kalousek-Ebrahimi said. “When people meet those outcomes, there is a cost outcome for the payer.”