Get Full Government Meeting Transcripts, Videos, & Alerts Forever!
Get email alerts on the Health Plan Networks topic
No spam. Unsubscribe anytime.
Blue Shield reports TRIO rollout, adds selective Sutter facilities to network
Summary
Blue Shield told the HSS board that Jan. 1 TRIO auto‑enrollment covered roughly 14,500 members (about $13.5M in projected 2018 savings), corrected an auto‑enrollment error for some Meritage Sonoma members, and added select Sutter ambulatory surgical centers and other hospitals to the TRIO network after negotiation.
Jeanette Moon, Blue Shield of California, told the Health Service Board that TRIO implementation reached an early enrollment milestone: about 14,500 members were enrolled as of Jan. 1 and Blue Shield estimated roughly $13.5 million in 2018 savings from that cohort, with further compounding savings if enrollment holds or grows.
Moon explained the auto‑enrollment logic: members were auto‑enrolled only when every family member in a household used a TRIO provider. That logic led to an inadvertent auto‑enrollment of 31 subscribers tied to Meritage Sonoma divisions that were not intended to be part of TRIO; Blue Shield identified the error and moved those members back to AccessPlus.
Moon also said Sutter Health — previously resistant to TRIO participation — reengaged after enrollment data were available and Blue Shield negotiated inclusion of a set of Sutter ambulatory surgical centers in San Francisco and Alameda, and certain campuses such as Eden Medical Center and others in the East Bay effective Jan. 1. Moon described adding those sites as an enhancement to network access that helps fill geographic gaps in the I‑580/I‑880 corridor.
Board members asked about the enrollment logic, the scope of added Sutter facilities and whether other employer groups participate in TRIO; Moon said the initial January uptick was led by HSS membership and she would follow up with more precise participation counts and a roster of added facilities. Acting Director Griggs and board members said the market changes and provider negotiations make the overall TRIO savings and access improvements meaningful for the system’s long‑term cost objectives.
The board requested follow‑up on specific provider lists and a clearer description of enrollment methodology and impact across plan cohorts.
