Life at Blue Cross (BCBSMA)

                           Weekly Recap/Journals 

In order to get credit, I had responsibilities most of the other interns did not have to worry about. One of them being writing a weekly recap or journal for my supervisor and academic adviser (Professor Glavin). Below are exact copies of those journals. I couldn't imagine a better way to share this experience. This internship was truly a blessing. Not every rising junior in the Healthcare field can say I worked with Blue Cross Blue Shields of Mass. Matter of fact, there is only one other student I know from Stonehill who can relate.

Blue Cross is govern by the Blue Cross Blue Shields Association with 93.3million members. On a lower scale, BCBSMA is a 13.8billion company with 3,500 employees and about 2.8million members. That's 34% of the total state population (6.5M Residents). I can go on for days about Blue Cross statistics.

I was fortunate enough to work with some of the best leaders in the company and the Network Contracting Department, Steve Moorehead (ex Senior Director) and Stephanie Graham (Director and my supervisor). Steve is unfortunately no longer at Blue Cross after 9-years. He was offered a job at corporate CVS and felt it was the right time. Also the great location, only 30mins away from his House in Hopkinton rather than an hour & 45mins commute into Boston. Fun fact, Steve lives two towns away from me. I plan on continuing the relationship when I get back to the States. Steve is also a Stonehill Alumni. When I was first introduced to Steve, he was extremely excited to see me like he knew me or something. In my head I was like, why is this dude so excited to meet me? Am I this wanted around here? But then I of course soon enough found out he was a Stonehill Alum and he hired me. One of my favorite memories of Steve was exchanging Stonehill Stories. 

Stephanie on the other hand has a twin who went to Stonehill. I swear Blue Cross is being taken over by Stonehill College. It's also a huge family business. Everyone and their Grand parents, Cousins, Aunts, Uncles, Moms and Dads work there. But you know what they say, it's not about what you know, it's about who you know. Going back to Steph, she is one of the smartest people I've ever worked for. Every question lead to another question. My mind was blown away every time I had a conversation with Steph, no exaggeration.  She is an expert at what she does. She is also one of the toughest people I've ever worked with. Like I said to her in my thank you letter, I haven't been that challenged by anyone in my life and I meant it. My high school Wrestling coach transformed me into a decent Wrestler in a very short period time and is known for being one f the toughest coaches in the state; but he has nothing on Steph. She had high expectations and meant business. Although she was so tough on me, and I wish I had a more low key leader sometimes, I couldn't have asked for a better supervisor. She has been mentored by great leaders like Steve Moorehead and all she wanted to do was pass that down to me. And that is an honor. I can only get better from here. I'm not going to say much about how much she thought me, read my journals and you will see exactly what I mean. 
Thanks to the many other coworkers who made my experiences at Blue Cross so heavenly. Guys like Khiem Tran and Daniel Green. These guys I know I was be friends with. The networking will never stop. 
 

Week 1: June 3-7, 2013 
Overall Thoughts: I obviously had no idea what I was getting myself into because I had no background knowledge on Network Contracting. After this week I can say I have a basic knowledge on Network contracting, what the department does, what my specific job is in contracting, and who it benefits and how. Based on what I know, I actually love it! And because I love my job and overall purpose behind it, I want to become more involved and learn more. There are so many different component of contracting and I am aware I only have two months, so I plan on taking it all in and learn as much as possible. Mostly because the next two months will determine if I reapply, because contracting is something I would like to do in the near future or move on to another internship in pursuit of my future job. I did not exactly expect to be apart of so many conference meetings. It’s only my first week and if I’m not mistaken, I have sat on 11 conference meetings. First day was rough; I thought I was in another country where the people speak a totally different language from me. It sounded familiar because I’ve taken a couple classes, but couldn’t actually understand what was going on. All it took was two days, and about 6 meetings, many questions and things started to click. I am actually excited to see how I improve weekly. It may take me awhile to actually contribute or question anyone’s thoughts because I’m still a little fish in a ginormous ocean of sharks but the confidence will come eventually. Last but not the least, I love the fact that the internship is absolutely nothing like the image of a typical internship; lots of filing, organizing, the average stuff. I love the fact that I am actually being treated as if I was a member of the team or a full time employee. I’m being challenged to work on advance projects like Kheim’s (Contracting team member) Treo Analysis/excel project. The note taking at conference meetings and presenting assignment (assigned by my supervisor) is something I am also excited about because it will keep me focus and actually learn the business while I am here. 

What I’ve learned: 

I learned the difference between HMO and PPO. A member under HMO has a PCP within the health plan’s network. A member has to be referred by a provider. HMO service is managed care and is overall cheaper than PPO. As a PPO member, you have a network of doctors to choose from. Because it is not managed care, it could get a little expensive for the member. As a result, the contracting is in the process of creating a more efficient system. The name of the project is the PPO Reform. I am also becoming a little more familiar with the PCP Attribution. Members are attributed to a specific provider monthly or annually base on claim history. I learned that a claim is written after member’s visit to a provider. Within the Networking team are the analysis team who does more of the prep and creating of the contract and the negotiators who actually do the negotiating with providers. In my opinion, the main objective of networking contracting is to find efficient ways of improving the quality of healthcare. Because of my back ground experience in data entry and inquiry cards at Stonehill’s admission, I was able to adopt to Treo Analysis a lot easier. Seems complicated at first but all it took was playing around and familiarizing myself with it. The hour and a half-ish explanation on what Treo is, what is does and why we use it definitely made it easier. As of the excel portion, I did have a very basic background knowledge so pulling the data wasn’t much of a problem. The calculations I am currently working my way around. Much like the Treo Analysis, it seems complicated but I know I will overcome it eventually.  

Week 2: June 10-14, 2013  
Overall Thoughts: This week was definitely a more focused week. Last week I had the opportunity to sit on general meetings; trends, score cards, the Sleep Management project etc. This week the meetings were mostly contracting focused. First meeting of the week was on Terminated Providers which also relates to the PPO Attribution. This meeting took place on Monday. Later that day I went to a meeting having to do with legal questions relating to the PPO Attribution. My third meeting of the week was pretty much an update of the PPO Attribution and the Payment Reform. The PPO update was my first official documenting. In other words I was assigned to take notes which will be used for future updates and for those who weren’t at the meeting. I have been taking notes since the first day of the internship. I’m now going to have to focus a little more and take quality notes because they are eventually going to be presented. Yesterday (Thursday 13th) being my first official documenting, I felt as if I was under pressure this time. It is a bit challenging trying to keep track of questions and important points that are brought up through out the meeting. My guess is that the process of documenting a meeting is one of those activities that get easier as time progressed. This week was overall a great learning experience. I was able to finish the 2010 Medicare Analysis (my first project). After being taught by Kheim Tran (The Consultant) at the end of last week, it was time to put apply it. I’m not the type who hears directions and get it the first time. I needed a guide so I created my own and customized it the way I understood. Aside from the calculation section, I no longer need the guide; writing things down repetitively helps implant information in my head. The guide is really there if I ever forget the little details. Understanding VLOOKUP and Cell Anchoring was very accomplishing. Like every challenging task, you feel relieved when it eventually clicks. I used to say to myself, I am not the sitting at the desk type. Which I am not outside of work, but after my experience with Stonehill Admission, I realized it is not as awful as people make it, as long as you love what you are doing; perfect example with the Treo Service/Medicare analysis project. Every time I’m in the zone, I don’t want to stop or interrupted. The next goal is to understand the data enough to interpret it.  

What I’ve learned:  

PPO Attribution & Reform: PPO Attribution relates to members while PPO Reform has to do with providers and the payment process. PPO members are attributed to a provider Organization aka a provider’s network or group once a year. This attribution process is done from patient’s claim history; recent physician visit, physician visited most frequently, etc. Patient data must be disclosed to assign PCP to facilitate & coordinate care. Members have the right to change their PCP after attribution. A physician can not decline or reject a member’s data. The official term is “cherry picking”. Cherry picking is a big no no in the healthcare industry. There are laws that protect members from being victims of cherry picking. Providers can declare a closed panel, but can not accept other patients after declaring a closed panel. A letter is sent to a member I think ever time their information or medical file is shared with a new provider or Provider Organization (PO). A provider is ineligible for attribution if he/she is deceased or retired. The question that’s up in the air right now is; Do “we” the team has to notify a member every time they attributed?” There are 3 options:  
Option 1: Freeze the attribution annually or quarterly  Option 2: Attribute monthly, only notify member if attributed group changes, not individual PCP  Option 3: Notify a new member each time attributed PCP changes, based on monthly attribution, before sharing data.  Option 4: Notify member annually even if monthly attribution logic change and include language in notification letter reserving the right to change attribution PCP based on claims activity.  Major Problems: Notifying member monthly might be annoying to the member and annually might be an overload.   As of Thursday’s meeting, the 13th of June, option 2 was favored by the group.  

   
Week 3: July 1-3, 2013  
Overall Thoughts: 

This week was by far the slowest week I’ve had here at BCBSMA although it was a short week. I was able to complete my assigned projects (TREO Analysis & PPO Payment Reform-Attribution update) before heading off for vacation. As a result, I did not have any major assignments to focus on. I needed to stay productive so I used the unlimited down times as an opportunity to broaden my knowledge on the Contracting Department. I basically did a lot of reading. I completed both parts of the AQC Contract, the Sleep Management Project, and the summery of the Chapter 224 of The Acts of 2012 packet. I also updated the common BCBSMA lingo document I’ve been working on for the past couple weeks. The process of writing the update daily has made a huge impact on the level I’m at right now with Contracting. In other words, the process of updating the document is where majority of my learning takes place. The document is a reference I can always return to when I stumble on a term, phrase or an acronym. It wasn’t until the end of Tuesday when I was assigned a new project on Network Contracting approach and addressing the issues of the rising cost of Healthcare. The goal is to read the packet thoroughly, analyze it and ask questions. The next step is to take the important details in the document and create a four or five page PowerPoint. The reading itself as fairly doable, but the PowerPoint is going to be a challenge because of the number of pages that is required. Talking a 27 page document and creating a five page slide takes an immense amount of details; but it can be done. Fortunately, there is a lot of room for creativity, which I am excited bout. There is currently no dead line, but the goal is to keep Stephanie (supervisor) updated in about a week and a half.    

What I learned:

Every work day here in the Contracting department is a learning experience. There hasn’t been a day where I haven’t learned anything new, especially during conference meetings. Monday’s PCP Attribution meeting went great as usual, mostly because I’m starting to understand the language and the overall objectives of the project. The main focus of the meeting was the PCP Attribution letter update. The letter is broken down into several parts to avoid confusion or frustration for members. The first paragraph summarizes the purpose of the letter which is; to assign members to a PCP to help ensure member access high quality healthcare. The letter then provides members a link for further information on Chapter 224 Acts. The second part of the letter talks about the member’s coverage (PPO). The information established that there will be no major changes to the plan. The third part elaborated on the Primary Care Physician while the last section stresses the sharing of member’s information. The key point in the sharing of information is that only CERTAIN information will be shared. Meaning relevant information (doctor & hospital visits, medical conditions, prescriptions), not member’s medical history. The letter is estimated to go out in December 2013, but before then, Accounts, Brokers and Physicians will have to be notified. The process of notifying Accounts, Brokers & Physicians will take place in November. Members will be notified four weeks before the letters go out. One of the major reasons Physicians are notified before the mailing of letters is to prevent phone calls from random members stating they have been attributed to a Physician who may not have their data. Members can of course opt out of the attribution or switch physicians. The deadline to opt out of attribution hasn’t been established. The only major change that was brought up was regarding the language in the first paragraph about the law (CH 224). “Mass law requires that we assign…..” It was brought up that we (contracting team and other departments involved with PCP Attribution) have to be mindful of the language because the intention for the Attribution is for the PPO Reform and not Chapter 224. Relevant changes are currently being made.  
During the team meeting on Tuesday Stephanie (Supervisor) talked about consolidated score card which is put together by the Finance Department. Although the topic did not relate much to the PPO Payment reform which I’m more involved with; it helped me understand more of the Network Contracting language. I became more aware of the types of hospitals (Children’s, Steward, etc) and Physician groups (PCMH, PCPIP, Atrius etc).   
Premium is another topic I became more familiar with this week. I heard the term for the first time in my foundation class back freshman year but never fully grasp the meaning of it. After sitting down with Khiem, I learned that premium is largely about risk management. Unlike deductable, a premium is paid by employers and employees. The cost of Premium is based on underlining factors; medical history, demographics, location etc.) The lower or higher the risk, the lower or higher the premium rate.  

Week 4: July 8-12, 2013  
Overall Thoughts:

This past week was by far the most productive week I’ve had in Contracting. I started on a new project (Single Contract Agreement), finished the reading portion of the Network Contracting Approach project, got a good start on creating an outline which will allow me to easily create a power point, and began the comparison portion of Khiem’s Treo Analysis project. I was also able to complete a huge amount of the Chapter 224 legislature summery packet. The Chapter 224 reading wasn’t required. I wanted to get a better sense of what it is and its objectives. I also felt it was important to have background knowledge on the legislature in order to understand the Network Contracting Approach. I’m realizing that a soli percentage of my internship is reading. It makes sense because in order for me to better understand the business, I need to do a lot of extended readings on the different topics that are brought up in the conference meetings and projects. Talking about projects, I had the pleasure of meeting with Jenn Lessor (Consultant) this past Wednesday about the APR-DRG project. Meeting with Jenn allowed me to get my questions answered and wrap my head around the project. Like usual, I need to go back to it, read a little more in dept in order to fully understand it enough to explain in my own words. 

What I learned: 

Single Case Agreement

In my understanding, the Case Agreement Contract is an agreement between Blue Cross and Providers for out-of-network services. Members are no longer charged for balance bill because majority of members can not afford it. Blue Cross Networking Contracting team then negotiates with the Providers to lower the charge. Sometimes they come to an agreement and in some cases they don’t and Blue Cross has to pay the full amount. I was given access to the hard documents and excel spreadsheet. In the file is the contract along with the dates it was complicated, the contract leader’s name, the provider signature, and the Contract Director and VP’s signature.  The excel file has more specific details on the contract and it is of course well organized. It includes Provider’s name, date of service, patient’s name, charges and more. My job was to determine if the contracts were available or not. I was to type “Yes” or “No” under the contract column. The next step of the project is to track down each missing contract, create a new spread sheet to filter out those that are missing and eventually scan each document and save it to the appropriate folder.  
Net Working Contracting Approach  The Network Contracting Approach according to the reading is a document base off chapter 224 legislature. Chapter 224 was passed in 2012 as a result of the rising cost of healthcare in Massachusetts. According to the document, Massachusetts spending on Health Care is 15% higher than the rest of the country. The Network Contracting Approach document is the Contracting Department’s actual approach on the issues and what they as a department can do to decrease cost while continuing to provide quality care. Some of the major issues that came up were the rise in unit cost and premium rate. The most interesting fact was that 90% of BCBSMA’s premium dollar is spent towards the reimbursement of Providers and Hospitals.  

Week 5 (15-19)  
Overall Thoughts 

 As of today Friday the 19th, I’ve been associated with Blue Cross for about a month, two weeks and two days; realistically only about five weeks because of the week and a half I had taken off for Peer Mentor commitments. Looking at the calendar, I have exactly five weeks left. It feels like yesterday when I had my orientation. Although I’m only half way into the internship, I’m thinking about the possibilities of returning in the winter after my abroad experience. My goal for the next half on the internship is to go the extra mile, and establish the relation that’s required to become a returning intern. Network Contracting is my first internship and I am fortunate that it is within a company I’ve always dreamed about working for and a department I can see myself working with in the near future. Not many students get to find a dream job on the first try.   One of my major goals during my internship search was to get an experience in a healthcare environment. Unfortunately none of the internships I intentionally applied for had the combination of providers and patients. I could have gotten that experience in a hospital setting but I didn’t apply to hospitals because of lack of experiences. Now here I am with network contracting, a department that works with providers and members. I could not have asked for a better opportunity.  
As of the rest of this week, it was a learning experience as usual. The Payment Reform meeting took place on Monday the 15th. I was a bit confused because there had been some updates I wasn’t aware of. My guess is that the updates were made during my two weeks break from the office. I did the best I could to understand the changes that had been made. I still have questions about it but I’m sure they will be answered soon.  I was able to complete Khiem’s Treo Comparison project to calculate the variance. The results weren’t exactly what Khiem expected but I plan to set a meeting between the three of us (Stephanie & Khiem) to review them.  
Earlier this week was also the College Relations Summer Development Program that’s held every week for all the summer interns here at BCBSMA. It allows us, the interns to get familiarized with different aspects of the company. This past week, we took a trip to OED (The Quincy location) for a presentation on the basics of Managed Care. Everything sounded familiar as a Network Contracting intern and a Healthcare Administration major, but it also answered some questions I had in mind about premiums and deductible. I’m looking forward to next week’s meeting back at OED on Member Service and to connect with more of the interns.  

What I Learned   

PCP Attribution Update: The topic of the past meeting was provider communication. I was introduced to many new terms in the last Attribution meeting. Some are more self explanatory and than others. Terms like self-insured and non-self insured. My guess of self-insured members is members who have their own companies or are self employed. If this is accurate, it would make sense that a fully insured member is an individual who is employed by someone other than themselves; someone who offers them employee benefits (health insurance).  How does it relate to the PCP Attribution project? That’s the pieces of the puzzle I’m still trying to figure out. I’m aware that some of the major questions that are yet to be answered are whether the Attribution should be mailed to self-insured members. Also, what should be the process for self-insured Accounts? Someone then later stated that the letter doesn’t apply to self-insured members but we would like to include them. It was then brought up that notifying self-insured members wasn’t for courtesy but for business reasons. It also wasn’t exactly for HIPAA or Legal matters. It could be both, but more for business reasons, according to one of the associates. My assumption is the letter is originally customized to be sent to fully insured members.   

The term roaster was also through around a couple times. It was brought up that a member roaster will not be shared with a provider unless it is in the contract? It was also said that no roaster will be provider unless a member take the letter into the physician’s office and say I’ve been attributed. Here are the two options in this case: We can confirm if there is a match up or if the information is accurate 
If the Physician request for one  

Basics of Manage Care 
As simple as it sound, I learned that under health insurance, especially as a network, the healthy pay for the sick. It makes total sense, but that may also explain the controversial behind the idea of mass insurance. No one wants to take the money they work for and have it go to some other’s person’s health benefits. I personally think it make sense morally because everyone will get sick or exposed to danger at some point in their lives and they may need someone’s financial support. Not necessarily in terms on mass health, but it does make sense in terms of premium. I also learned that in an employer based system, the employers pay a larger amount for insurance. Medical under writing also came up in the meeting. To summarize the meaning, it tells the doctor or insurance your bad habits. That may include alcoholism or tobacco smoking. The information will determine if a person will be insured or how your cost will be customized. I learned that this system is illegal in Massachuttess but legal in other states.  
 
Week 6 (22-26)  
Overall Thoughts  

The count down for me started last week. I’m not counting down because I can’t wait to leave; that is absolutely not the case. I’m honestly counting down until the day I leave for Italy. At the same time it is a constant reminder that my time here is coming to an end, and it’s coming by faster than I would like. I have so much more to learn and such little time. The count down is also a reminder that I have to continue to get better. Talking about getting better, I had my mid-term evaluation this week. My self evaluation was based on how I’ve improved during the past month comparing to my abilities before BCBSMA. Stephanie’s (supervisor) evaluation wasn’t necessarily based on my improvement at BCBSMA because she did not know me prior to the internship. Her evaluation was if I’m not mistaken, was based on my time here as an employee comparing to the rest of the team. I’m usually very aware of my weakness, so we agreed on most things I needed to improve. The others were due to lack of communication on my part. I’m usually good with keeping her updated but all it took was one incident. That just shows that I need to work on consistency. Long story short, aside from my public speaking abilities, I’m not the type to crack under pressure or react negatively to constructive criticism. I’m plan on taking those criticisms and learn from it and continue getting better. One of my favorite quotes by Ron Burton (first Afro-American drafted to the Pats) is; “once you start getting better, you are no, longer good.” That just means there is always room for improvement and I plan on getting a better evaluation next time around.   
As for the rest of the week, the Contracting department had a meeting with Audit and Risk Management. The entire meeting was completely over my head but I learned a thing or two about Audit and Risk Management. For this week’s College Relationships Development program, we (the interns) had the privilege of going back to OED (Quincy Location) for a Member Service presentation and tour of the facility. This was by far my favorite meeting because it opened my eyes to other internship opportunities. I was also able to return to the APR-DRG project this week. Return as in, rereading the PowerPoint from my meeting with Jenn (associate) in order to get a better understanding of the project. I was also able to wrap most of the projects I’ve been working on. Projects like TREO Comparison (an extension of the Treo Analysis project) and drafted PowerPoint of the Network Contracting Approach. The next step to the approach project is to get it edited by Steph (supervisor) in our next one on one meeting. The goal is to present the information to her (Steph) and Steve Moorehead (Senior Director of Contracting) in conclusion of my internship.  

What I learned:  
Audit and Risk Management  
One of the things I learned about Audit and Risk Management is that all of the executive Board is external and independent. From my understanding, most Audits are usually internal. They support both external and internal customers. In other words, they are every where, but can not be seen.  

Member Services Tour  
Member service is better known as MAPS at BCBSMA (Member Provider And Service). Its mission is deliver information as quickly and accurately as possible and to always put members first. The term Service EDGE is the foundation of the department. EDGE stands for; Education, Decisions, Guidance and Engagement. Its missions at its foundation were to “take members out of the loop and increase member satisfaction”. The evolution is to educate members to ensure first contact resolution. The quote “taking members put of the loop” alarmed me a little from a Contractor perspective. I raised my hand and commented on how it contradicted Network Contracting‘s goal of making members more reliable in the Network Contracting approach document. Terra (Member Service rep and Stonehill Alum) then clarified the difference between foundation and evolution. It made a lot more sense afterwards. Terra also explained the department’s training and hiring process. This is truly a very intense process; from the training curriculum to the application of skills. Like I stated before, one of the major reasons I feel privileged to be interning in Network Contracting is because of it’s relation with members and providers; a direction I’ve always wanted to take in healthcare. I came into Contracting not aware of jobs that connect both aspect of healthcare or insurance and now I’m leaving in less than a month with a better idea of what I want to do in the near future. I don’t think there is a more exciting feeling then that.  

APR-DRG APR-DRG is a topic that has been in the picture since the day of my arrival. I’m constantly hearing the term APR-DRG, but yet never knew what it meant. As part of my learning experience I decided to meet with Jenn Lessor who is closely involved with the project. During this meeting I learned that APR-DRG is a payment method along with many others that Healthcare Organizations use to pay hospitals and Provider groups. The base payment models at a basic level include Fee For Service (charges & Fee Schedule), Bundled Payment (Per Diem, DRG, Episode Case Rate) and Global Payment (Partial Capitation, Full Capitation). There is so many different aspect of DRG I don’t know where to start. I’m going to leave it as it is. Moral of the story is I have a better idea of APR-DRG and the other types of payment methodologies out there.   

Week 7 (29-2)  
Overall Thoughts  

This past Monday was my first informal presentation on the Treo Analysis and Comparison project. I personally thought I did well because of the amount of time I took to prepare for the presentation itself. As of my knowledge on the topic, I knew enough to provide details on each topic and posed questions that may not have concrete answers. I had been working on the project for the past month and was very familiar with all the major stages and process of getting the final results. There were some questions asked that I couldn’t answer because it was over my head. I have been exposed to a lot of topics but at the same time, there are more things I am still not aware of. For example:  having “runout” problems. I wasn’t aware of that being a possible factor for why certain results may have occurred; so I did not take it into consideration. I did also get some good feedbacks. There is nothing better then possible feedbacks. But then of course it wasn’t a perfect presentation.  
We had our by weekly team meeting on Tuesday and like usual I was a bit clueless. I have been with Contracting for two months and topics like PPO Payment Reform, AQC Contract and PPO Attribution make more sense. And then there are topics regarding weekly scorecard I still can not wrap my head around. Talking about PPO Payment Reform, I got to sit in a meeting Wednesday. It was my second time getting invited and surprisingly I walked away with more understanding then the first time.  
As for everything else, I’m on my final stages of the Single Case Agreement documents. I’ve emailed all associates with missing documents, scanned and saved the ones I have in the PC Resource file, and checked it in the excel spread sheet. The next step is to hopefully get the missing ones if they can be found and update the information.  
The Network Contracting Approach PowerPoint is more challenging then I anticipated. I initially thought I was simply going to read a document and make a PowerPoint slide; boy was I wrong. The biggest thing for me is, understanding what it is that I’m talking about as well as explaining in my own words. The other challenging factor is applying what I’ve learned over the past couple month (projects like PPO Attribution and Treo Analysis) to the Approach document. I have done exactly that, the problem is placing the information where it is most relevant. It’s difficult because I haven’t fully wrapped my head around everything that Network Contracting does. The little details needed to connect the puzzle haven’t clicked yet, which is why creating this 5 page PowerPoint is this challenging.     

What I learned 
Treo Comparison Presentation 
The presentation was also a learning experience. I learn that it is important to not just present graphs relevant to the topic but to understand and be able to give detailed explanation about the graph.  

Week 8 (August 5-9)  

Overall Thoughts: 
This week was quite a busy week. Not busy in terms of workload but because I moved around a lot. My major focus was on completing the Network Contracting Approach PowerPoint and having it finalized based on Steph’s (Supervisor) edits. The next process would be preparing for the presentation. Talking about presentation, during the biweekly team meeting on Tuesday, my coworkers and I discovered that Steve Moorehead (Senior Director) is leaving the company after nine years. It was a bit upsetting but the man has to do what is best for him and his family. I can not imagine what it is like to let go something you’ve invested in for so long. Steve and Steph are the two people I was originally supposed to present the Contracting Approach PowerPoint to. Unfortunately, neither of them is going to be around on the last week of my internship. I may have to present to other members of the team.  
The other goal this week was to stay in touch with contract leaders who still have missing documents and update the information as they come. All I can do at this point is, wait patiently for information on missing contracts.  
The college development program hosted two major programs for the interns this week. The first event took place on Wednesday at George’s Island. It was a service day organized for all Blue Cross College and High School interns. The name of the project was called Save the Harbor Save the Bay. The project is Boston’s mission to save the Harbor by keeping it clean and making it a popular tourist location. Our mission was to pick up trash on the beaches. Ironically, there wasn’t much trash to clean. With almost 200 interns and campers, it took no ore then ten minutes. Service day turned into interns bonding with recruiter day. I can not complain because it was a perfect opportunity to get to know the other interns and our recruiter Jason Dekow on a personal level.  
The other event was a presentation by the Marketing Department at the OED location (Quincy).  

What I learned:

George’s Island was a historic site not too many people have heard of. The Island was once used as a prison for soldiers of war during the civil war. African American men were captured and brought to George’s Island. The facility is now deserted and is now used for tourism.  

Marketing Presentation  

The Marketing presentation was by far my favorite of the College Development presentation. These presentations are meant to give us, the interns a better understanding of the company and the other departments that are available. The presentation covered all aspect of the company. From the company’s mission at a higher level, to the Marketing Department’s guiding principles, the Brand, customers, its financial status and job opportunities.    
The mission of the BCBSMA is to make quality healthcare affordable and promises to always put its members first. The Marketing department has three guiding principles; “prominence not dominance”. As a result BCBSMA is not known to having full page ads in newspapers or magazine and having super bowl ads like most companies. This principle truly answered the question of why I’ve never seen a Blue Cross commercial on TV. The second principle is, “confidence not arrogance”. Blue Cross believes in the idea of leading from behind and not broad casting everything. Much like an average person, businesses go from confidence to arrogance in a matter of time. The last principle is; “humanize, Personalize, and contemporarize”. Thinking about it, it is the principles, values, and morals of the company that attracts me more to Blue Cross. I believe in being a humble leader and the idea of giving back to the community, to the people who contributed to your success. If Blue Cross did not believe in those principles, Service and Blue Crew day would not exist. I learned that service day is a day started two years ago by the corporate citizen department. For an entire day, the company is shut down and all of its 3,500+ associates go and volunteer all across the city of Boston. Blue Crew is a service day for specific departments. Not too many companies now a day are willing to give up an entire day to give back to the city of Boston.      
 
Week 9 (August 12-16)  
Overall Thoughts: 

This week was what I consider a low key week. I didn’t have any meetings to go to but yet a lot still happened. Starting Monday, I had a pleasure of joining my team on their Blue Crew service day at the Food Project farm in Lincoln. The team was separated into two different groups. Each group was assigned to two or three high school interns who facilitated the entire event. We started off with an introduction of the Food Project, who they are, what they do and why. We then introduced ourselves to the High School interns who proceeded with my favorite ice breaker, “Where the wind blows”. As a second year Peer Mentor at Stonehill, I was very familiar with the activity. The rules were slightly tweaked. Instead of coming up with your own “where the wind blows” comment/question, they had us pick up Agricultural facts from a basket to be read out loud if you were the person in the circle. If the fact related to you, as in the people making the circle, you would run to an empty pair of shoe. You the person who was recently in the circle would flip the card over and read another fact about agricultural. The second fact was more informational while the first was more of a question. After the intro activity, the interns lead us to the potatoes garden. The task for my group was to harvest potatoes. We had to get down and dirty to dig for potatoes. I felt like a kid again, playing in dirt. It was quite an experience. I can’t speak for everyone else but I had a blast. To conclude the program, the interns had us once again stand in a circle once again. They then lead us through another activity. This time it was called “Step in to the Circle”. “Step into the circle” is a debreathing activity I’m also familiar as member of ALANA-A Big Brother Big Sister Program back at school. The ALANA Program is very similar to the Peer Mentor Program but more diversity focused. Also instead of working with 20-30 students at a time, you are assigned to one or two “siblings”.   
Aside from Blue Crew service day, my week was mostly occupied with finalizing the Network Contracting Approach PowerPoint and getting ready to present to my team members. The finalizing of the presentation was a little stressful but I completely it. The next step was presenting it today (Friday) to my team members; Khiem Tran, Keri Rouse, Steve Moorehead (Senior Director) and my supervisor Stephanie Graham. I’ve had to present for Stephanie and Khiem in the past. The rest of the crew I hadn’t presented in front of before so I felt a bit nervous. The numbers intimidated me a little. I did get though the presentation and received good feedbacks. I couldn’t have been anymore relieved to be done. Aside from smaller projects, I worked on the presentation including the reading of the actual document for about a month, made 5-6 edits and took about 3 different approaches.   

My other focus this week was, staying in contact with team members with missing Single Case contracts. I did hear back from the last two contract leaders (Khiem & Meli) about their contracts. The next step will be to update the information on the excel spreadsheet and complete the project before the end of my internship on Thursday the 22nd.  

What I learned  
Blue Crew Day  

I learned that the Food Project was very influential in local towns as well as the Boston area. They harvest fresh vegetables and fruits for neighboring towns. Locals pay ahead of time to have fresh groceries delivered to their houses from time to time. As for the city of Boston, the Food Project assigns workers to the city of Boston to help inner city families make gardens as a way to encourage healthy eating.  

Network Contracting Approach Presentation 
One of the major lessons I learned from the project was patients and persistency. Patient because working with a document like the Approach document, there is no one correct answer. Because there is not a correct answer, things are likely to change. And of course with changes comes constant updates. This is where it’s more important to stay persistent instead of giving up or getting frustrated. I mean, as an intern giving up was not an option, so I continued to work at it, making changes and updates.  One thing I also realized was that just completing the task wasn’t good enough until it was up to my leader’s standards. So many times I thought I had, but it wasn’t quite there. I surely felt accomplished when it eventually came together. I guess this is all apart of the real world experience, looking pass your own understanding.  
  
One of my biggest accomplishment at Blue Cross was coming up with an initiative for the Green Team (Green@Blue). Here is the introduction:

STOP. WHY GREEN? 

As a student at Stonehill College in Easton, MA, sustainability has become its own culture on campus, held in top-tier priority alongside diversity and inclusion 

At my BCBSMA Orientation, I couldn’t help but observe the numerous employees with plastic water bottles which prompted my research 

Green @ Blue has already had success: Minimizing print production, powering down PC’s at the end of each work day, and introducing duplex (double-sided) printing to all shared printers.  

Let’s continue the motion! To reach the 15% waste reduction by 2015 goal, I hope that my initiative will be taken into consideration before the next sustainability scorecard update in 2015. 

The objective of this project was supply all employees with reusable water bottle. That way there would be no excuse for having plastic water bottles in the facility. Despite how much money it will save them in the long run, and how much healthier,  people are not willing to spend their own money. I was once that stubborn guy. If you have any interest in a copy of the actual document, let me know so I can send you a copy. Hopefully everyone will have reusable water bottles when I go back. Now that is legacy. One of the major reasons I decided to create the initiative was to make a lasting impact. Aside from seeing water bottles everywhere, I thought to myself, what can I do for them to remember me when I'm gone? What can I do to have them saying, that's that intern? And so I decided to give it a shot. What did I have to lose? I was uncertain about what my supervisor would think so I did not mention it until the project was completed. In the end, she loved it and so did everyone else. The initiative is currently being looked at by the Green Team. I should be getting an update soon! Thank you for taking your time to read my blog. I understand they are always a long read. Lookout for my first blog from Firenze, Italia. It will blow you away how heavenly this place is.