Breaking Barriers: How Industry Collaboration is Transforming Healthcare

Welcome to Architect Health’s The Front Door Newsletter! In this newsletter, Architect Health’s Co-founder & CEO, Sohum Shah, interviews healthcare executives, founders, and experts on healthcare innovation, digital health, and preventative care. The goal is to identify pain points in these spaces and paint visions on how to address them, inspiring decision makers at traditional healthcare organizations.

Today’s interview features health care transformation advocate and social impact leader, Shruti Kothari. Shruti shares her perspectives on industry-wide collaboration, the importance of data-sharing, and the evolution of digital health.

Interview Key Takeaways:

• Scaling Innovation: Blue Shield California’s (BSC’s) Industry Initiatives is tackling systemic misalignments to scale innovation through collaboration across the healthcare ecosystem.

• Data Transparency: Connecting for Better Health (C4BH) is driving data sharing and interoperability, addressing long-standing barriers to transparency in CA.

• Digital Health Meets Value-Based Care: Integrating digital health tools with advanced payment models is key to sustainable healthcare transformation and improved outcomes.

• Integrated Care: Innovative financing models and partnerships with telehealth vendors are expanding access and enabling better care coordination.

• Point-Solution Fatigue: BSC is prioritizing industry-wide collaboration to replace fragmented solutions with integrated, strategic frameworks.

Listen to the Podcast:

• Spotify

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Currently, Shruti leads Industry Initiatives for Blue Shield of California, where she is focused on scaling and sustaining health care transformation through industry alignment and policy movement.

She supports improved experiences for patients, families, and providers. Shruti has worked as a health educator, community mobilizer, quality improvement leader, early-stage startup operator, a conduit between large systems and the innovation ecosystem. In this capacity she has worked for the American Cancer Society, Stanford, Kaiser Permanente, and Blue Shield of California.

Shruti is also the Founder of Women of Community, an organization committed to increasing representation of Women of Color in health care leadership. And the Co-Founder of Crown Society, a company who’s mission is to support the young caregiver community. Shruti is on the board for the Family Caregiver Alliance, is a board advisor for the Asian Pacific Fund, and is an Advisor for the End Well Foundation, ScaleHealth, and Reverence.

In 2022, Business Insider named Shruti as one of their top 30 under 40 leaders in health care, and in 2024 Rock Health named Shruti as a top 50 in Digital Health.

Origin of Blue Shield California's Industry Initiatives

Sohum: What is the origin of Blue Shield California's Industry Initiatives and what is the purpose behind it? How does it differ from health equity and quality teams within payer organizations?

Shruti: The Industry Initiatives team at Blue Shield California was established to tackle the challenges of scaling healthcare transformation. Unlike traditional health equity and quality teams, this initiative focuses on collaboration and cooperation across the healthcare ecosystem to overcome policy and industry misalignments that hinder the scaling of innovative solutions. It's forward-thinking for an organization to resource a team like this, and it differs from innovation teams as well, as it targets barriers to scale rather than just testing and piloting new ideas.

This team was born out of a leadership executive offsite where our senior leaders recognized the need for such a function to achieve our transformation goals. It's crucial for a team like this to have buy-in from top-level leaders and be properly resourced. The concept is about addressing the fragmentation in the healthcare system by working with diverse stakeholders, including competitors, to align industry-wide initiatives.

Launching Connecting for Better Health (C4BH)

Sohum: Blue Shield CA helped launch the nonprofit, Connecting for Better Health (C4BH) to discuss policy development, share the latest evidence, and develop a collective outlook to advance data sharing in California in a forum style setting. What sparked the need for this? How is Blue Shield CA continuing to increase data transparency and interoperability?

Shruti: The need for C4BH was sparked by the importance of data sharing, highlighted during the pandemic. Historically, California has been passionate about data sharing, but misaligned incentives hindered progress. The pandemic demonstrated the effectiveness of data sharing mandates in other states, making it a ripe time for change. C4BH was launched to bring together diverse stakeholders, and legislation was passed in 2021 to enhance data sharing capabilities in California.

Data sharing is foundational for many healthcare innovations, but it's often overlooked as it's not considered "sexy." However, it's crucial for effective healthcare management. Blue Shield of California continues to work on increasing data transparency through initiatives like C4BH, ensuring that all players in the ecosystem are aligned and committed to advancing data sharing.

Evolution of Digital Health

Sohum: How has your view of digital health (e.g., telehealth apps, virtual-first care, etc.) changed over time? Pre-pandemic vs post-pandemic? Looking at your crystal ball, what does the future hold in store?

Shruti: My view of digital health has evolved significantly. The pandemic highlighted the need for flexible care modalities, such as virtual care. However, traditional fee-for-service models are insufficient for these new modalities. The future holds the integration of digital health with value-based payment models, allowing for more flexible and effective care delivery.

Digital health tools are essential, but they require structural support, such as data sharing and advanced payment models. The pandemic accelerated the adoption of telehealth, but it also exposed the need for better payment models that support these innovations. As we move forward, the integration of digital health with value-based care will be critical for sustainable transformation.

Intersection of Digital Health and Value-Based Care

Sohum: Digital health and value-based care are two of the most talked about advancements in modern healthcare. Where do you see a natural intersection between the two? Can value-based care arrangements drive the adoption of digital health, and vice versa? How is your Industry Initiatives team thinking about payment innovation in VBC for digital health?

Shruti: Value-based care and digital health innovation go hand in hand. Value-based care arrangements create financial incentives to adopt digital health tools that can streamline care, improve outcomes, and enhance patient engagement. Digital health, in turn, enables more effective value-based contracting by providing data-driven insights.

Our team focuses on rethinking payment models to empower primary care providers to focus on comprehensive patient-centered care, leading to better health outcomes and efficiency. We've worked on advanced payment models in primary care, which have shown promising outcomes. However, scaling this requires collaboration with other health plans to align on payment models and digital infrastructure.

Integrating Primary Care and Behavioral Health

Sohum: You’re a big proponent of access to primary care and behavioral health. How can we better integrate the two and how can we increase access to that care? How does Blue Shield of CA think about partnering with telehealth vendors to support these initiatives?

Shruti: Integrating primary care and behavioral health is crucial, as primary care often serves as the front door for mental health services. However, the current financing models don't support this integration effectively. Blue Shield of California supports this integration through collaborating with providers to support their implementation of integrated models such as CoCM by removing co-pays to provide at no cost to members. We also contract with digital health platforms to expand access, particularly in areas with limited local providers.

Financing is a key challenge; we need better payment models that support integrated care. This involves setting up structures that allow for comprehensive care coordination without adding undue burden on providers.

Addressing Point-Solution Fatigue

Sohum: The concept of point-solution fatigue has been voiced consistently by payers, providers, and even patients themselves. What approach has Blue Shield CA been taking to address that? What novel approaches might you recommend to plans combating this problem today?

Shruti: Blue Shield California addresses point-solution fatigue by emphasizing cooperation and collaboration across the industry. This involves working with competitors and other stakeholders to align on broader strategic goals rather than adopting isolated solutions.

The healthcare industry is fragmented, and this fragmentation often leads to inefficiencies. By collaborating more effectively, plans can avoid the fatigue associated with managing multiple point solutions and instead focus on integrating solutions that fit into larger strategic frameworks.

Motivations for Onboarding Digital Health Solutions

Sohum: What roles do cost savings, quality of care, and member engagement play in plans' motivation to onboard digital health and healthtech solutions?

Shruti: Cost savings, quality of care, and member engagement are key factors motivating health plans to adopt digital health solutions. However, it's also important for digital health companies to understand the ecosystem they're entering. They should demonstrate how their solutions can seamlessly integrate into existing systems without adding undue burden.

Founders should focus on showing how their products support the broader strategic goals of health plans, including data sharing and payment model innovations. This involves understanding the operational complexities and regulatory challenges faced by health plans.

Understanding Member Needs

Sohum: You and Covered California CMO, Dr. Monica Soni, co-authored a Fierce Healthcare article on embracing the complexity of lived experiences in healthcare. Both of your personal experiences were foundational to the work you’ve committed your lives to progressing. How can the healthcare system better understand the needs of its members and provide personalized care that closes gaps?

Shruti: The healthcare system can better understand member needs by embracing the complexity of lived experiences. This involves recognizing the individuality of members' experiences and tailoring care to address these unique needs. It's crucial to avoid making assumptions about populations and to design solutions with diverse perspectives at the table.

Empowering primary care and prioritizing data sharing are key strategies for closing systematic gaps. Dr. Soni highlights the importance of not making assumptions about populations and ensuring that strategies are designed with diverse perspectives.

Leadership Beyond Blue Shield of California

Sohum: Shruti - you are a leader both in and out of the health insurance ecosystem. You launched Women of Community, are an Advisory Council member for the Asian Pacific Fund, co-founded Crown Society, and are on the board of the Family Caregiver Alliance. What motivates you to support these initiatives and why is it expressed in these ways / paths? How does that relate to your work at Blue Shield CA?

Shruti: My mission is to contribute positively to healthcare and healthcare systems. Everything I do is connected to this goal. My career has evolved from being a health educator to working in quality improvement and innovation, always focusing on systemic change.

My involvement in various initiatives reflects my passion for equity and support for underrepresented groups. These efforts align with my work at Blue Shield of California by promoting broader healthcare transformation and increasing representation in leadership.

Looking Forward in 2025

Sohum: What are you most looking forward to for the rest of 2025? What are some changes or trends in healthcare you are most excited to witness?

Shruti: I'm excited about the growing recognition of the importance of foundational elements like data sharing and payment models in driving healthcare innovation. The future holds the potential for more collaborative approaches across the industry, leading to streamlined systems and better support for digital health innovations.

I envision a future where every major health plan has an industry initiatives team working together to address systemic barriers, similar to the success of initiatives like Connecting for Better Health. This collaboration will be crucial for advancing healthcare transformation sustainably.

Architect Health’s telehealth vendor management operating system simplifies vendor evaluation, accelerates payer procurement, and ensures measurable ROI for payers. Architect Health is supercharging payer purchasing and eliminating the telehealth bottleneck, relieving point-solution fatigue. Architect's Digital Health Quality Index has vetted and scored thousands of telehealth solutions on efficacy, company reliability, and health equity. Co-founders Sohum Shah and Sidd Hariharan have deep expertise working with health plans and have built care management programs and aligned technology for Humana and BlueCross BlueShield. Architect Health is backed by Drive Capital, Entrepreneurs Roundtable Accelerator (ERA), Cherrystone Angel Group, Plug and Play Ventures, Service Provider Capital, and strategic advisors.

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