We’re better together. We share ideas, resources and our platform with our Blue plan partners. Together, we find common solutions that enable the Blues to save time and money.     


Candid Conversations: The NASCO Experience

Looking out of her office window over the mountains and the hillsides, Dawn Schneiderman, Vice President and Chief Administrative Officer for Blue Cross and Blue Shield of Vermont (BCBSVT), noted that snow was covering the ground.

“It’s very snowy,” she said. “It’s beautiful.” 

When we asked Ruth Greene, Vice President and Chief Financial Officer for BCBSVT, about how many feet of snow were on the ground, she instinctively responded that there were a lot, but she mentioned that they were currently experiencing a warm spell. 

Maybe it was the excitement in the air that made a snow-covered, 45-degree day feel warm, or maybe it DID feel warm to these native Vermonters, who are accustomed to bone-chilling temperatures. Nonetheless, there was a lot to be excited about. The go-live date for the final migration of BCBSVT business onto the NASCO platform was quickly approaching, and hundreds of NASCO and BCBSVT employees had been working tirelessly on the successful migration of this business over the past few years. This was no small feat. In December 2014, BCBSVT began planning for the transition of its entire book of business to NASCO. It was the largest project in BCBSVT’s history, but the health plan was eager to partner with NASCO to ensure that it could serve its members well into the future of healthcare with scalable and agile products and services. 

While the two companies were mid-migration, BCBSVT made the decision to further its partnership with NASCO by investing in the company to become an owner. 

The more we learned about NASCO, the more we wanted to be part of NASCO,” said Greene. “It was NASCO’s business model of serving Blue plans and reinvesting back into the system that made it easy for BCBSVT to make the decision to invest in NASCO.

“In my day job as the CFO, I developed the business case as to why becoming an owner of NASCO made sense, and I really felt like that was a great story, and I felt good about it,” continued Greene. “And here we are on the eve of our final big push of implementation, and I’m still feeling good about it and like we’re all in this together!”


Helping You Win Is Our No. 1 Job

NASCO is a purpose-driven company — that purpose is to help the Blues remain competitive in their markets. 

Just five short years ago, CareFirst BlueCross BlueShield (CareFirst) was looking for ways to improve its Blue plan IPP scores. Now, CareFirst is in the top 10 for Blue plan IPP scores. This improvement took place gradually, with the addition of several products and process, including the introduction of BeneFACT℠, NASCO’s suite of applications that supports group benefit implementation functions. The use of BeneFACT is one of the factors that helped CareFirst improve benefit coding efficiency, accuracy and timeliness of delivery and decrease the number of claims on stop. CareFirst’s adjustment rates also have dropped, and the company received its highest ever first pass rate in 2018.

“We have improved the quality, accuracy and efficiency with which we are conducting our business,” said Sally Miller, Vice President of Large Group Operations for CareFirst. “I am so proud of the work that we’ve been able to accomplish with NASCO’s help and the position that it has put us in to be able to grow our business.”

While exceptional performance is certainly paramount in winning new business, healthcare data security is also a top concern for groups and consumers. NASCO knows firsthand just how important securing and protecting data is, because we respond to thousands of questions each year within audits and assessments initiated by our plan partners, as well as by their customers. 

Following healthcare industry security events, NASCO invested nearly $6 million in security capabilities to accelerate our SOC2 and HITRUST certifications, and we continue to invest millions annually to maintain security compliance. We retained our HITRUST certification against version 8.1 of the common security framework in 2018, and we’ll recertify HITRUST against version 9.1 in 2019. Also in 2018, we delivered our SOC2 Type II certification and issued a SOC3 to assist our plan partners with new group sales. The SOC3 report is an executive summary of our SOC2 that can be provided during new business pursuits to independently assure health plans’ potential customers that appropriate security controls are in place to protect employee data. 

Whether we’re innovating new products, securing and protecting data, improving efficiencies or decreasing administrative costs, NASCO remains focused on ensuring that our plan partners are primed to win.   

Blue Cross Blue Shield of Michigan Keeps It Simple With MembersEdge


“Keep it simple” is a mantra. But do health plans really walk the walk? Blue Cross Blue Shield of Michigan (BCBSM) does!  

Several years ago, BCBSM moved a large portion of its membership to MembersEdge® because it needed an integrated membership and billing system that would position it for a more consumer-centric healthcare market and support multiple lines of business, including individual, group, self-funded and ancillary. Once on MembersEdge, BCBSM experienced improvements in the overall efficiency of enrollment, membership and billing and, with the automation available through the product, the health plan’s costs to perform self-funded billing functions decreased significantly. As the positive results rolled in, it was an easy decision for BCBSM to move all of its membership to MembersEdge.  

MembersEdge is NASCO’s enrollment, membership, billing and rating product that helps health plans meet members where they are. You no longer have to wait for a claim to come in before you connect with your members. MembersEdge can help you engage with members in real time before they even know they need you. And with flexible setup and automation, your members will have a seamless experience from enrollment to payment. That’s what we all want, isn’t it? 

“The demand for Amazon-like experiences is continuing to grow with our members and group decision makers,” said Chris Maier, Vice President of Claims, Enrollment and Program Management for BCBSM. “We decided that we needed to enable these experiences through a single membership and billing solution versus building redundant capabilities across multiple solutions.”

By migrating all of its business onto the MembersEdge platform, BCBSM will reduce costs by alleviating the need to maintain multiple platforms and redundant capabilities. In addition, the health plan is growing its self-funded business through expansions in small- and mid-sized markets. As this business grows, MembersEdge will scale to effectively handle the growth and increase efficiencies through automation. 

MembersEdge offers much more automation than other membership and billing solutions,” said Maier. “In fact, with MembersEdge’s automation capabilities, we can increase our self-funded business without increasing staff.

Beyond the automation that enables efficient membership and billing operations, MembersEdge provides real-time processing and plug-and-play integration with other solutions. BCBSM has integrated MembersEdge with a number of its quoting and enrollment solutions in a way that enables rapid (most occurring in less than two business days) new and renewing group enrollment, which is critical to the renewal cycle.  

BCBSM’s decision was all about keeping it simple: simplifying administration, reducing costs, refining processes, enabling growth and improving the consumer experience. Don’t you think it’s time to make your life simpler?