25 Years of Community-First Work Prepares BCBSNC Foundation for a Strained Health System: Colleen Briggs, MBA

In part 1 of an interview with The American Journal of Managed Care^® (AJMC^®), Colleen Briggs, MBA, president of the Blue Cross and Blue Shield of North Carolina (BCBSNC) Foundation, reflects on the organization’s impact across the state as it marks its 25th anniversary.

She also discusses how, in her role as president, she is carrying forward the foundation’s legacy while helping shape its future direction. Briggs further outlines how the organization is evolving to remain effective amid rising health care costs and increasing system complexity.

Learn more about the work of the BCBSNC Foundation here.

AJMC: Reflecting on the Foundation's first 25 years, what stands out to you as its most meaningful contribution to improving health across North Carolina?

Briggs: I think what stands out most to me from the Foundation's 25 years, and it's really what drew me to this organization, is more the approach, the thoughtfulness, and how we've really thought about changing the health care system in partnership with the community. I think there are 3 attributes that make it really unique.

The first is just that it's always been in a really deep partnership with communities. All of our work really starts with listening and investing along communities and really not prescribing solutions. The Foundation has been around for 25 years, but it's built on a legacy of Blue Cross that's been operating in North Carolina for over 90 years. Again, I think it really reflects that deep partnership, trust, and connection in the communities of North Carolina.

I think the second really unique thing about the approach is that it really takes a long-term view. If you're trying to change our health care system and the conditions around health, you have to make long-term, sustained investments. I think a good example is the work the Foundation did around oral health. It really took years of sustained investments that built the infrastructure with communities, the leadership, and some of the education, credibility, and coalition that were needed to change outdated policies and improve access to oral health in communities across the state.

Then, I think the third piece that's really unique about the Foundation's approach over the last 25 years is the focus on addressing some of the root causes driving the health challenges we see. Our work really focuses on why we see these persistent gaps in health outcomes, really focusing on some of those root causes and what's really driving that, whether that be some of the challenges in the workforce, payment policies, affordability, or prevention, so that we can move beyond just the consequences, really looking at how we address those underlying issues that we know are leading to all the downstream effects that we're all feeling every day.

AJMC: Stepping into the role as president, how are you carrying forward the Foundation's legacy while shaping its future direction?

Briggs: Stepping into this role, I really do have so much respect for the legacy that the Foundation has built over the last 25 years. That legacy is so rooted in listening to the community, really trusting the nonprofits that are closest to the work and standing alongside them to make sure that we're focused on community-led solutions.

Carrying forward means that we're going to continue to stay grounded in those principles. Listening first, leading in partnerships: those values really have not changed. What also doesn’t change is our vision and our purpose, which is to improve the health and well-being of our customers and communities and to try to make North Carolina one of the healthiest states in a generation.

But at the same time, shaping the Foundation's future, it has to be responsive to what we're hearing from communities. They're telling us that we also have to evolve, given the significant challenges that we're seeing in health care. Some of the big changes that we are really changing or really trying to be responsive to what we're hearing in communities are, first, we continue to hear philanthropy alone is not enough, given the complexity and the scale of the challenges in the health care system. Health care costs continue to rise, the overall system, as you know, faces a lot of strain. Communities are looking for partners who can bring funding but also the strength of the company, so our data, our expertise, our convening power, and our products and services so that we can actually scale solutions. One big shift is really bringing the full strength of our organization to help tackle these issues.

I think the second big shift, again, being responsive to what we heard in communities, is to sharpen our focus on where we can have the greatest impact. What we heard from communities is that means we should really narrow in on youth mental health, improving health through food, and improving access to care. Those issues are so important because not only are they issues that communities are facing, but they're also leverage points for the whole health care system. I mean, a lot of these are going to influence long-term health outcomes, affordability, and how well the health care system works for North Carolina.

I think the third really big shift for us is that a lot of organizations are asking everyone to be more accountable; how do we know that we're actually having the impact that we want to have? We really are focused on using our data as a tool for learning and accountability to know if we are having the impact that we want to have.

One more thing that we continue to hear from communities that will also be reflected going forward is going to be the focus on collaboration. Some of the most impactful work that we've done has been in partnership with others. Given the complexity of these issues, we really are going to be looking to focus on where we can partner with others to have a greater impact.

With all of that, what you're seeing is that it's a lot of building on the lessons learned from the past and a continuation of those values but also being responsive to the community, with a sharper focus, greater urgency, and now new tools that are going to let us have a greater impact and be even more responsive to the communities that we're serving.

AJMC: How is the Foundation adapting to remain effective and responsible amid rising health care costs and increasing system complexity?

Briggs: This is such a challenging moment for communities and philanthropy, but in health care, the pressure is even more acute. We're seeing costs that are skyrocketing. We're seeing access to care that continues to erode. Many of the places that provide care are under significant strain, and a lot of the basic supports that keep people healthy, like food, behavioral health, and community-based prevention, are being weakened. We know it's a challenging environment, but we also believe that we're prepared to respond because we continue to stay closely connected to the communities that are on the front lines of these issues.

We have teams that are embedded in all 100 counties of the state to make sure that our strategies adapt and reflect what it is that communities need right now to help them navigate the challenges that they're facing in health care. Related, we're investing in the leaders who are on those front lines of dealing with these issues. We're investing in those health care leaders’ ability to build infrastructure, modernize, be more adaptive, and position themselves to navigate this complexity.

The next big area that we think is positioning us well to be able to respond is that we are focused on some of the biggest cost drivers of long-term health care costs: access to care, youth, mental health, and improving health through food. We continue to see that when we invest in prevention like this, it helps the system get less expensive. It actually drives down costs, so the more that we can invest in early intervention and preventive care, the more we can improve health outcomes and actually reduce costs for everyone. Finally, again, we are continuing to show up with the full strength of our organization, doing everything that we can in this environment to make sure that we are scaling what works, using that data to really understand what works and what doesn't, and then using the strength of our organization to help propel that forward so that we can actually scale some of these effective solutions that we're seeing.

For us to be responsive, we obviously have to be effective and responsible, and we're doing that by really making sure that we're pairing that urgency with a focus. We're still carrying that compassion for the work but also with discipline on where we can have the greatest impact and then really making sure that the work that we can do in this moment is going to be measured and accountable so that we know whether we are actually delivering value and improving health outcomes and improving costs in a very challenging environment.