Show, Don’t Tell: How Blue Cross Blue Shield of Massachusetts Drives Innovation

Andy Cook
April 23, 2018
Interview with Molly Mazzaferro and Liz Magee of Blue Cross Blue Shield

Healthcare might not be the first industry you picture when you think of innovation. But Molly Mazzaferro and Liz Magee are working hard to change that.

They’re part of leading the charge on innovation at Blue Cross Blue Shield of Massachusetts. Molly’s Director of the Innovation Team, which operates like a start-up within a much larger company and uses human-centered design as a foundation for problem-solving.

Though the Innovation Team is only two years underway, it’s already having an impact on the culture of BCBSMA. Liz is a consultant in Blue Cross’s internal Business Consulting Group, working on projects throughout the company, including launching an emerging solutions program.  

Her team uses lean methodologies to drive process improvement and redesign across the organization. Both teams provide important support across the business in driving both small and large-scale innovation.

A Startup within a Big Company

The Innovation Team was created in order to help the larger organization adopt new approaches when facing age-old problems. BCBSMA’s senior leadership has tasked the Innovation Team with two primary charges:

  1. Drive internal cultural change: arm associates with new ways of solving problems by incorporating new tools and techniques into their day-to-day work.
  2. Drive innovation “at the edge of the business”: think much bigger, broader, and bolder about healthcare. This means thinking beyond just health insurance, and instead, gaining a deeper understanding of people’s engagement with their own health and our society’s systems.

These are important goals, and yet, they can be difficult to achieve within the context of a large, longstanding organization like Blue Cross Blue Shield of Massachusetts. At nearly 100 years old, BCBSMA now serves almost three million members and has 25,000 Massachusetts businesses as clients. Many organizations of this size struggle with change, but BCBSMA knows they must embrace innovation if they’re going to remain the highest-rated health plan in Massachusetts.

BCBSMA has long been a very mission-driven organization. They focus on making quality healthcare affordable and putting members first. And yet, this mission takes on a new meaning in the age of technology. They’re shifting their thinking to be more “consumer-centric” and truly understand the experience of each individual:

“While we’ve always had the mindset of putting members first from a service perspective, we’re now trying to put the pieces together on what that experience is like in terms of the tools and technologies we can give them to help them drive their healthcare.”

This is where the Innovation Team comes in, helping internal teams adopt this new mindset. The Innovation Team has a culture and mission all its own. They leverage an innovation methodology called “human-centered design” or “design thinking,” putting the customer at the center of every problem they try to solve. They leverage techniques like fostering empathy and including members in the problem-solving process; this lets them innovate better “for and with their customers”.

Cultural Conflict

The Innovation Team’s approach is occasionally at odds with that of a larger company; many BCBSMA associates and leaders have worked there for decades, and while their tenure is a testament to the company’s strong inherent core values, it also means that many have seen things that were tried in the past and failed. Overcoming this fear of failure requires coaching and encouragement to embrace new practices and approaches to solving age-old problems.

So, how do you get others to adopt your way of thinking within an almost 100-year organization? It’s no easy task. Mazzaferro notes:

“A lot of the underlying tools we use focus on flexibility and being agile and exhibiting a bias towards action mindset. This can be hard for a big organization.”

Furthermore, as a health insurance company, it’s Blue Cross’s job to manage risk. Innovation and risk management can find themselves at odds; it’s risky to go out on limbs. Though innovation isn’t always in the DNA of a large and complex healthcare organization, Molly and Liz find creative ways of helping people see the value of new approaches.

Getting Others on Board

The Innovation Team’s progress has been slow but steady. In order to change behaviors, they start by changing attitudes.

“In any big organization, change is hard, and it’s no different here…we’ve been working hard to get people in the mindset of being open and willing to try something new, embracing this methodology to pave the way for change.”

Part of the process has included launching a curriculum of hands-on, experiential design workshops. The Innovation Team developed these workshops to let people experience what they mean by “human-centered design.” They’ve found that it’s easier to get buy-in when they can show, rather than tell. Instead of explaining the design thinking methodology with a powerpoint, they lead people through the process with a real-life business challenge, so that participants see how the end result can makes his/her job better.

Communicating the Need for Change Internally

Mazzaferro has been struck by the importance of communication when it comes to organizational change. Even small words make a difference. They’ve started using the phrase “design doing” instead of “design thinking” to underscore the value of having a bias to action. Her team’s success also depends on others buying into their vision, and buy-in so often depends on the Innovation Team’s ability to tell a good story.

“At this stage in our growth, we’re starting to put more strategic focus around communication and making sure we’re telling the story in the most compelling way we can.”

She wants to increase visibility into what they’re doing and leverages many channels to accomplish her goal. They have a team website that’s separate and distinct from the corporate website, clarifying what their services include. They also publish stories and updates on their intranet, promoting past successes and initiatives that are currently underway. Their Chief Innovation Officer, Robin Glasco, also works hard to get the word out. She publishes content via blog posts and social channels and speaks frequently at innovation events both locally and nationally.

The Innovation Team has already noticed a change in attitude because of their robust communication strategy. They receive feedback on initiatives they’ve shared, and they’ve started to see an uptick on their social channels.

Communicating with the Outside World

Mazzaferro and Magee think about external communication nearly as much as internal communication. They work hard to infuse thinking from other people and industries. Inviting external perspectives is relatively new for their organization, but it’s necessary when confronting such tough challenges.

“Healthcare is so complex and challenging, if we could have solved this on our own by now, we would have. The biggest and boldest solutions are only going to come by inviting folks with different backgrounds and perspectives to be part of that journey with us.”

This commitment to collaboration, another key tenet of design thinking, has helped to shift internal thinking and culture at Blue Cross Blue Shield of Massachusetts. The company has a better handle on external pressures and disruption in the healthcare space. They recognize that change will come, and BCBSMA must be part of the change.

The stakes are high, not only for Blue Cross, but for all of us who rely on them. The biggest question now is how they’ll adapt in the market and how quickly they can do it. Given their commitment to innovation and their focus on communication, BCBSMA seems primed to reinvent the way that all of us engage with our health.