Wellvolution, Blue Shield of California's digital health program, helps members in the insurer's Medicaid and commercial offerings manage chronic conditions and mental health.
Blue Shield of California recently rolled out a Spanish-language version of the platform and added options for hypertension.
Becker's caught up with Angie Kalousek-Ebrahimi, senior director of lifestyle medicine at Blue Shield of California, to discuss how the program helps members manage their mental and physical health in tandem.
Editor's note: This conversation has been edited for length and clarity.
Question: You recently announced Wellvolution is available in Spanish. What was the process like?
Angie Kalousek-Ebrahimi: It was a long time coming. We had been working with our partners, Solera, to make the conversion and the translation to Spanish. We know about a quarter of Californians speak Spanish at home, so that's a really important context. In our Medi-Cal population, about half are Spanish speakers. So it's really important to us that the programs that we offer in Wellvolution that people who don't speak English as their first language are still able to get the benefits of all those programs.
There was a lot of technical integration that we had to do and a lot of coordination that we have to do because we have a number of different providers on the Wellvolution network. Each of them had to go through the conversion to Spanish language. It was a huge effort, but I'm really happy that we finally accomplished it and were able to launch.
Q: Can you explain the different programs you offer through Wellvolution?
AKE: The very first one we offered when we started Wellvolution in 2019 is our cardio-metabolic network. Our cardio-metabolic programs include diabetes prevention, diabetes treatment and reversal, obesity management, and we've added hypertension. That really covers a lot of the cardio-metabolic conditions that can be addressed through lifestyle, predominantly diet and exercise and stress reduction, etc.
We also have a mental health network. We have two programs, both under Headspace. Headspace … is the app that provides support to help members with resilience, stress reduction, mindfulness, meditation and improved sleep. It's sort of like your pocket companion or your pocket tool that you can pull out at anytime when you need to take a moment for reflection.
Then we have Headspace Care, which used to be called Ginger. It's now a part of the overarching Headspace company. Headspace Care is a little bit more up the continuum in terms of it's not just that you need to destress, but you are feeling anxious or depressed. There's a digital cognitive behavioral therapy tool that is available with health coaches. It's part of a continuous program that allows you to achieve your goals.
We also know that sometimes when people go into Headspace Care, they indicate that they need some therapeutic intervention, meaning they're looking for a therapist, or the coach that they're working with on the digital side has determined that their acuity level is thus that they need therapeutic intervention. In that case, we have contracted with [Headspace's] larger therapeutic network and we can triage members into that kind of care. It's a really seamless experience as a member, going between a digital solution and a live therapist interaction.
Q: How do you integrate in-person and virtual care?
AKE: We see within Wellvolution programs complementing programs. For example, members who are enrolled in a diabetes treatment program, a lot of times there's a lot of major emotions that come with having to treat and reverse a chronic condition like diabetes. If they can also get involved in Headspace Care, they can work through those issues.
We're getting really amazing results within Headspace Care. We're seeing 80% of the members with moderate depression seeing improvement, and 76% with moderate to severe anxiety also saw improvement.
Q: You launched Wellvolution around four years ago. As you look back, what are you most proud of, and where do you hope the program is five years from now?
AKE: We've done a lot of work to grow the number of conditions that we're offering, and at the same time hone down the providers we're using. When we started Wellvolution, we had 40 or 50 different providers, and we quickly realized that not all are created equal. We learned from the outcomes that they were delivering, and now we're working with the absolute best, highest-performing providers in the Wellvolution network.
The other thing that we're really proud of — and many people come to me asking me for advice on how to do this — is that the way that we pay for the programs that we do is an entirely pay-for-performance model. We pay a fee based on enrollment, for sustained engagement and then for hitting clinically significant outcomes, and again when a member maintains those clinically significant outcomes. You're not paid a [per-member per-month fee] just for the pleasure of being there. You have to actually drive engagement and outcomes in order to get paid. I think that's really the future of value-based care, moving toward that pay-for-performance model.
We've seen a ton of growth over the past four years. We're getting close to 200,000 members on the platform. We're continually learning new ways to drive higher levels of engagement and adding different programs so more members have more ways to engage in Wellvolution.
When I think about where I want it to be in the next three to five years, I would love to see a million members on the platform. I'd love to see more conditions, and continuing to push the envelope where traditional medicine sometimes doesn't, where we really delve into this area of proactive nutrition that supports a member's health holistically, continuing on that path of expansion and growth.