GSC: becoming canada's first integrated health organisation

GSC: becoming canada's first integrated health organisation

Green Shield Canada tells us about becoming Canada's first health insurer to integrate health services, all with a strong social mission at its core.

Green Shield Canada (GSC) is best known as one of the country's largest health and dental benefits providers, and in the six decades since it was established has maintained its social mission at its core. 

Bill Wilkinson, a pharmacist from Windsor in Ontario, decided to start the company after a young mother visited his store and was faced with having to choose between paying for her daughter’s prescription or her own. This led Wilkinson, along with four other pharmacists, to create North America’s first pre-paid drug plan, a concept that is widely in use today. 

CEO and President Zahid Salman explains that GSC today remains committed to its structure as a not for profit, social enterprise whose business earnings are used to fund its social impact priorities. "Our business activities, community investment and health system advocacy work all support better health outcomes in our communities,” he says. "In the end, we operate for the purpose of making it easier for people to live their healthiest lives, and our mission is delivering meaningful solutions to improve health and wellbeing.  Our purpose and our mission are what guides our business and social impact priorities." 

To better serve its customers, GSC is currently repositioning itself, from being solely a health and dental benefits carrier to being Canada's only integrated health services organizsation with capability across health insurance, pharmacy benefits management, health and benefits administration, and health services delivery. Salman says this expansion will in turn help increase the company's social impact. It will generate greater funding and provide new service capabilities that can be deployed in local communities.

This has led to the current focus on digital transformation at the company, which will be crucial as GSC enters new markets and deploys new services. "A key component of the broader business transformation we are undergoing will be digital, as the vision for our future business models is digital-first," Salman says. "While GSC has always been strong from a technology perspective, as evidenced by our proprietary Advantage claims and pharmacy benefits management platform being used by other providers in the market, being digital-first across our business lines will need to be enabled by things like increased agility, having greater customer insight,  delivering improved analytics to our plan sponsors to support their decision making, and by better leveraging the cloud." 

The company recently took its first step along this journey by launching “GSC  everywhere”, a web and mobile portal that serves existing plan members, and that was co-designed with their input. "The aim was to be modern and flexible and ease navigation for the basics – claim submission and eligibility checks" David Willows, EVP for Digital, Innovation and Brand Experience explains. "Of course, it being 2021, we put in lots of API layers too, in order to allow our partners to plug in and bring added health services to our customers – all part of our vision of evolving into an integrated health services company.” 

The platform took existing legacy software and modernised it, and Willows explains they are planning to ramp up their digital capabilities. "We're moving to radically enhanced CRM capabilities, new data and analytics platforms, and developing an increased cloud posture. This is a much longer term initiative, over three to five years, and it will certainly be more complex for the organisation, but it will serve our commercial goal of moving from core health and dental benefits administration to an integrated healthcare company." 

Willows says that GSC's digital strategy was profoundly impacted by COVID-19, particularly in terms of delivering care virtually. "I look back at 2018 and 2019 when we were starting to strike our first investments in virtual care, and displaying these new capabilities to Canadian employers, and by extension, their plan members.  There was interest, but I'd say their thinking was that they didn't want to commit new or existing funding to it. 

"That changed quickly in March last year," he adds. "All of our data suggests that the attitude of plan sponsors and plan members has changed quickly. Namely, by living through a life of lockdown and not having access to traditional services, digital health services were more front of mind. The response has been universally positive, both with the customer experience and satisfaction with health outcomes. Now we have a landscape where we can expand these offerings." 

GSC's partnership with Accenture is enabling the company to add new capabilities it hasn't had before. "We just built the new GSC everywhere platform, and historically we had built and managed these platforms on our own. We were confident upgrading such offerings on our own," Willows says. "But when we are talking about introducing vastly increased CRM capabilities, changing and adding data and analytics platforms, and increasing our cloud posture, a lot of this will be new to the organisation. We're able to say that for this next generation work we need to enhance our team with additional subject matter experts and certainly Accenture is a company that has done this with organisations small, medium, and large many times before." 

Having a strong partner ecosystem will be vital to this digital mission. "It was a really critical topic even before we contemplated some of the specific aspects of our digital transformation," Willows says. "People are doing good work in Ddigital hHealth in Canada… they're ahead of the curve and in the market already. As a company of 1200 people, we're not going to build everything from scratch. Early on we made strong connections in the technology and virtual health communities, and have curated, we think, offerings on the virtual health side that are the best of the breed. We certainly will not be able to deliver on our vision without having very strong, mutually beneficial ties with both technology and virtual health partners." 

Ultimately, Salman says that the priorities of GSC's digital journey are driven by the needs of customers. "They're looking for convenient, seamless services that can be accessed whenever they want, from wherever they want. From a services perspective their needs have evolved rapidly as a result of the COVID-19 pandemic, and now they're increasingly focused on things like mental health, faster and easier access to physicians, and more cost-effective procurement of prescription drugs. 

"The pandemic has shown everyone the great potential solutions like digital mental health, telemedicine and e-pharmacy have to improve the patient experience. The digital transformation we're contemplating will enhance our ability to not only deliver digital services like these, but also connect them where relevant, and help patients more effectively navigate care." 

There are also benefits to the workforce, as things like automation will add speed and efficiency to routine tasks. "This will enable GSC to better focus on helping people, which is the reason people choose to work here," Salman says.  

Looking ahead, GSC has several projects in line with its social mission. One is the Green Door Project, launched in 2020 with the University of Toronto to establish a new dental clinic providing free care to underserved populations, alongside conducting a five-year research programme. "This is actually the largest single donation to dental public health research in Canadian history," Salman says. 

"We'll also be launching a signature women’s mental health programme later in 2021. Recogniszing the adverse impacts COVID-19 has had on female participation rates in the workforce, our aim is to provide necessary supports to reverse that trend, with a particular view to facilitating women’s movement into leadership roles, recognizsing both historic underrepresentation as well as the ways the pandemic has further exacerbated this. We think this is a very important programme that we'll expand over the next three to five years.

"From a business perspective, we'll remain focused on our multi-year business and digital transformations, with the goal of repositioning Green Shield as an integrated health services organisation. By doing this we believe we will help improve the health and wellbeing of Canadians right across the country.

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