Five Questions With: Dr. Gus Manocchia

Senior vice president and chief medical officer at Blue Cross & Blue Shield of Rhode Island talks about a new service-focused initiative. More

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Five Questions With: Dr. Gus Manocchia

COURTESY BCBSRI
"As a physician, I must think carefully and creatively about the most efficient and affordable way to get patients what they need."
Posted 10/8/12

Dr. Gus Manocchia, senior vice president and chief medical officer at Blue Cross & Blue Shield of Rhode Island, will be honored on Oct. 10 for his volunteer efforts at the Rhode Island Free Clinic.

Providence Business News asked Manocchia to share his insights about volunteering – and the new initiative at Blue Cross focused on a day of volunteer service at more than 20 community agencies across Rhode Island.

PBN: What was the impetus for launching the volunteer effort, known as “Blue across Rhode Island?”

MANOCCHIA: Blue Cross is a local, nonprofit company, and Rhode Islanders are our family, friends, and neighbors.

We take our responsibility as a community partner seriously – and that’s very important to me as an employee. In the last 10 years, our BlueAngel Community Grant program has contributed more than $1.9 million to 43 organizations, touching the lives of nearly 200,000 Rhode Islanders.

Giving back also means volunteering, and our employees volunteered for more than 3,500 hours just last year. It’s something they’re passionate about as individuals and as employees.

But we all know that no matter how much time you give, there’s always more to do. With Blue across Rhode Island, we had the opportunity to help more than 20 Rhode Island nonprofits in a single day.

On the day of Blue across Rhode Island, I was at Thundermist Health Center in Woonsocket. We harvested and conducted a fall clean up of their community garden, cleaned up the bike path, helped prepare for their annual Duck Race, and set up a farmer’s market. While these activities may seem like relatively minor jobs, 60 Blue Cross employees were able to start and complete projects in one day that may have taken Thundermist staff months to complete. I think we all had a great sense of pride in the work we did for organizations that address the health and social needs of our community.

PBN: How do you, as a business executive, model the importance of volunteering?

MANOCCHIA: For the past seven years, I’ve had the honor of caring for many uninsured Rhode Islanders as a volunteer primary care physician at the Rhode Island Free Clinic. Helping patients who are in desperate need of primary care is a very rewarding and educational experience. Unfortunately, patients without access to care have a very difficult time navigating our complex healthcare system. As a physician, I must think carefully and creatively about the most efficient and affordable way to get patients what they need. Filling a simple prescription can pose many challenges for patients.

As you can imagine, I have a fond attachment to the Rhode Island Free Clinic and often encourage Blue Cross employees to volunteer there. As a result, the clinic has welcomed the support of many Blue Cross employees in both clinical and non-clinical roles.

PBN: The investment in the delivery of primary care through patient-centered medical homes has begun to reap results in outcomes and lowering of medical costs. What kinds of future investments does Blue Cross plan to make in these medical homes?

MANOCCHIA: As you mention, we’ve begun to see improvements in both clinical quality and overall health care costs in many of our patient-centered medical home program practices as compared to traditional primary care practices. We believe that strong physician leadership, use of electronic medical records, staff training and support, and a nurse case manager all contribute greatly to a successful transformation of the practice.

Given that we are seeing positive trends, we’ll be reaching out to traditional primary care practices that are working toward the patient-centered medical home model and help them successfully make the transition.

We’re also looking at how to better integrate both behavioral health and pharmacy services into the patient-centered medical home model because these services are so critical to our members’ care. Electronic health records are another essential component, and we’re supporting patient-centered medical homes in maximizing their use, so patients get all the advantages offered by this technology.

As we expand and improve the model, we’re also focusing on how to get more members to take advantage of it. That’s why we’ll continue to create products that encourage the use of patient-centered medical homes and engage members in their health.

PBN: What kinds of innovative designs will Blue Cross offer groups who have instituted workplace wellness campaigns?

MANOCCHIA: Blue Cross has been an avid supporter of workplace wellness campaigns and understands the importance of integrating them into the corporate culture – we do it for our own employees. Our plan designs are developed to provide employees and individuals with a health plan package that continues to provide comprehensive coverage with the added accountability for their health that builds from year to year. The workplace wellness campaigns that so many Rhode Island companies implement help support that accountability.

As an employer, Blue Cross faces the same challenges that other employers encounter regarding the increase employee health costs and is utilizing the very same plan designs other employers purchase for its own associates.

In 2011 at Blue Cross, it was a requirement for associates and domestic partners to complete and online personal health assessment, and to have medical and dental well visits.

If they did not, the associate was subject to an additional 10 percent in premium cost for the 2012 plan year – 92 percent of employees met the wellness requirements in 2011.

In 2012, we added HSA contributions and cash incentives for associates if they have a body mass index less than 30, and participate in a variety of worksite wellness activities such as blood pressure and cholesterol screenings, or nutrition classes.

We will continue to look at plan designs for our customers that encourage healthy lifestyles to address the rising costs of health care.

PBN: What do you see as the role of the patient in being able to exercise more control and responsibility for his or her health care treatments?

MANOCCHIA: For too long, the patient has been a passive participant in the health care system, with little involvement in decision-making. That’s changing. At Blue Cross, we believe the patient should be the center of the health care system, and patient-centered medical homes are turning that into reality.

With the primary care physician as the patient’s champion, the patient is actually given greater responsibility for his or her own health than in a traditional practice. The patient-centered medical home team is responsible for actively educating patients in behavior change and lifestyle modification, so patients can address illnesses that often respond to lifestyle changes alone, such as early hypertension and obesity. Patients can take charge of their health because they have the tools and support necessary to do so.

Going forward, as access to health care cost and quality information becomes the rule, patients will be able to make truly informed decisions about what care they’ll receive and where they’ll receive it.

Access to information is particularly important since there is now a greater emphasis on cost sharing. While employers have had to pass more costs on to employees to keep premiums affordable, this could actually benefit the system by encouraging patients to seek cost-effective care.

For example, if I have a health savings account and have to pay for the first $3,000 of care, I’m likely to have a more vested interest in asking questions about a recommended procedure. I may talk further with the physician about necessity, the benefits to doing it now versus later, and alternative treatments and cost. These are important questions. And when we’re all more involved consumers of health care, it benefits us as individuals and it benefits the health care system as a whole.

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