BCBSNC Foundation Evolved From Addressing Immediate Needs to Upstream Health Solutions: Katie Eyes, MSW

Amid the organization’s 25th anniversary, Katie Eyes, MSW, vice president of program and strategy for the Blue Cross and Blue Shield of North Carolina (BCBSNC) Foundation, spoke with The American Journal of Managed Care^® (AJMC^®) about its most meaningful impacts.

Over the course of her 18 years with the organization, she explained that the foundation has evolved from addressing immediate gaps in care to focusing more on upstream, systems-level solutions while adapting to increasingly complex challenges like rising costs, fragmented access, and persistent disparities in rural and underserved areas. Eyes emphasized that lasting change comes from working together to transform systems rather than acting alone.

Learn more about the foundation’s impact here.

This transcript has been edited lightly for clarity.

AJMC: Reflecting on the past 25 years, what do you see as the foundation’s most meaningful impact across North Carolina communities?

Eyes: From the beginning, the foundation was really founded based on this sort of powerful belief that everyone in North Carolina deserves the opportunity to be healthy. There are so many achievements that I'm proud that we've contributed to over the years to that goal, and we've had lots of different focus areas over the time period, but we've taken every evolution in our strategy and in our approach to philanthropy as a learning opportunity, and we're much better today based on what we've learned over the last 25 years, especially with regard to how we lean in, based on our unique identity as the BCBSNC Foundation.

What I'm most proud of, though, is the work that we've done to drive partnership and be partners to our grantees and others. That's because being a changemaker in the community, one of the people who are leading change in their field, can be really lonely. When we connect people who are pushing what's possible in their communities or their fields, I've seen magic happen. It helps build allies and connect people who are doing similar work. What takes one group 2 years to learn, others can apply immediately. They can develop peer connections, and you help new people develop hope that things can be different and better, and they can help maintain momentum when the going gets really hard.

In terms of what we've been able to evolve to, connecting our grantees to each other, to resources, to insights that come from the insurer perspective of BCBSNC, to experts in the BCBSNC building, we have that unique opportunity to contribute to those partnerships. That ability to convene people, to connect them, I think, has been a meaningful part of our story over the last 25 years.

AJMC: Over your 18 years with the foundation, how have you seen community-level challenges in youth mental health, access to care, and health through food evolve? How has the Foundation adapted its strategies and programs in response to those changing needs?

Eyes: I talked about how we've been rooted in partnership, working alongside nonprofits, health care providers, and community leaders. Initially, our role, when I started, was about helping close immediate gaps in care and support. As we've evolved and seen where our impact was driving lasting change, we've really focused our effort more intentionally on upstream solutions and investing in community-led approaches that improve health outcomes and help the system work better for everyone.

If anything, the challenges in our community space are getting more complex. The rising cost, the interrelation of different systems, and these persistent gaps, especially in rural and underserved areas, make it much harder for families to get the care and support they need. So, that's why we've really focused on the systems so that they're not only responsive to needs but also sustainable.

AJMC: What have been the most persistent barriers to improving outcomes in these areas, and how has the Foundation adjusted its strategies over time to address them?

Eyes: The world looks different from the way it did 25 years ago, so we definitely evolved. Changes in funding, access to care, and health care costs just continue to be persistent barriers, and they're growing. But I think it's that focus on systems change, because systems produce certain results, and ultimately, we need to change the system to change those results.

Oral health is an area that I focused on pretty specifically as a program officer for a period, and it's an area where we really can do better. Whether it's how we think about our teeth, and whether cavities or losing our teeth are preventable or inevitable, what we think about visiting the dentist, down to our emotional reaction of being in that office, or what the experience is like in that office, and even where care is delivered and how convenient it is, and, of course, the financial incentives, what things cost and how they're paid for.

All of those things need to be considered in order to have an impact at the level we need to bring that sort of level of health for everyone in North Carolina. Looking at the barriers that exist is a really important part of our work.

AJMC: How has the foundation's approach to partnering with community-based organizations evolved, and why are these relationships so important to maintain?

Eyes: I think our approach to partnering with community-based organizations has become much more intentional and collaborative over time. From the beginning, our work has been rooted in communities across North Carolina, especially in rural areas and places that have historically had fewer resources. But today, we see community organizations as essential partners in shaping the solutions that will work. When we're looking for that systems change, the insight from the community around the local context, because they're focused on the community's long-term resilience and ability to thrive, is so important.

About 10 years ago, we made it a priority to expand our support beyond grant dollars for a single purpose or a specific program to build out an approach to capacity building, technical assistance, convening, and well-being supports, all of which are part of how our approach is to partnering with community-based organizations as well. The experience of supporting grantees in that way, beyond just the programmatic grant, has led to deeper relationships, I'd say, more honest and candid relationships, which lead to greater insights from us and our grantees around what's working and what's not, and has helped us build out approaches that really balance long-term strategy with the ability to respond when needs or crises emerge.

That means when there's a hurricane or an event like the COVID-19 pandemic, some big disruption to the environment, or even just an executive transition at one of our grantee organizations, we are aware of it, we respond to it, and we go beyond that sort of specific programmatic grant to help bring more resources to bear on their work and be able to support them throughout whatever change is happening that might impact their programmatic work.

AJMC: Looking ahead, what lessons from the foundation's past work should most strongly guide its next 25 years?

Eyes: I think the most important lesson from our past 25 years is that lasting progress happens when we work together. “We” means the foundation, our grantees, others in philanthropy, and others in the field. We need to get clear together that change needs to happen, that the current state is not working, what the possibilities are, and find the places where we agree on how we can move forward together.

We did these listening tours across all 100 counties, and what we got there was remarkably consistent, and it reinforced that communities expect more than philanthropy alone. They want more partnership from us. They want more shared accountability, and they want to be cocreating these solutions that reflect local realities.

I think that's where we're headed now, and that’s what I'm really excited about. I'm really proud of the work over the history of the foundation, but the 25th anniversary isn't just about looking back. It's really a new opportunity for us to commit to pushing forward with some of those lessons and with urgency and purpose on our goals with others.