December 12, 2025 Newswires

Elevance Health Reflects On The Changed Role of Health Plans

Business Wire

By simplifying the healthcare experience, improving care coordination, and leveraging data-driven insights, Elevance Health affiliated health plans help members navigate a range of healthcare experiences with greater confidence

INDIANAPOLIS--(BUSINESS WIRE)--
As 2025 draws to a close, Elevance Health highlights how today’s health plans are evolving to better support their members in a broader range of situations that affect health, including cancer diagnoses, mental health crises, and unexpected health concerns during pregnancy. From employer-sponsored health insurance to government-sponsored programs, health plans are evolving to better support their members in a broader range of situations that affect health. In partnership with care providers, health plans strive to simplify the healthcare experience, personalize care, improve quality, and work with community organizations to improve health outcomes.

“It’s highly personal, our health,” said Dr. Shantanu Agrawal, chief health officer for Elevance Health. Those personal aspects weren’t typically addressed by the healthcare system in the past. “We have the ability to understand and address health on a more individual level, and we can support members in a way that works best for them.”

Taking a Broader View of Health

The traditional approach to healthcare has revolved around the medical and physical aspects of health. Measurements such as weight and blood pressure shaped healthcare decisions. Health plans primarily focused on helping people access and pay for their healthcare, and advocated for affordability, quality and safety. Today’s health plans have built upon that important foundation to include even better preventive care support, assistance in managing chronic disease, and integrating behavioral health.

“Decades of data demonstrate that helping people get and stay healthy takes more than focusing on physical factors alone,” Agrawal said. “Physical health influences behavioral health, and vice versa. Social factors have an impact on physical and behavioral health too. They should all be considered together, and this is why we need a whole-health approach.”

Elevance Health and its affiliated health plans take a broader view of health. One example of this approach is the recently expanded access to doula care. Research shows that women who receive doula care services, which include education, coaching and emotional support, experience better health outcomes than women who do not use doula care services. A certified doula can help women communicate with their doctors or midwives; they can ease the stress and physical demands of pregnancy, labor and delivery; and they help new parents ease into what is a significant life transition.

This broader view shows up in many of Elevance Health’s affiliated Medicare Advantage and Medicaid plans as well. These plans support members in meeting their individual health and social needs with funds for nutritious food, over-the-counter medications, and transportation services, all of which contribute to improving health outcomes.

Simplifying the Healthcare Experience

By delivering simplified, understandable, and comprehensive resources through easily accessible channels like the Sydney app, Elevance Health-affiliated plans support members in a way that fits their life and helps them better understand and use their benefits and services. Today’s health plans strive to simplify the experience for members and healthcare providers alike.

Health plans can better serve members with complex health conditions by improving care coordination and personalizing solutions. In one example, the Community Pharmacy Total Care (CPTC) program matches members with independent community pharmacists who add a personal touch. The program, in collaboration with CPESN USA, encompasses more than 500 pharmacies across 10 states and Washington, D.C. Advanced analytics help identify people who could benefit from the program, focusing on those with diabetes or chronic respiratory, cardiovascular, or behavioral health conditions.

Helping Members Navigate Healthcare with Confidence

Working in collaboration with high quality care providers across the nation, our affiliated plans reward a patient-centered, data-driven, coordinated-care approach. Members can also lean on care managers, experienced clinical professionals who help answer questions, overcome roadblocks, and quickly get the assistance they need.

“Members don’t expect their health insurance plan to help them navigate the healthcare system and make it work for them, but that’s exactly what our care managers do,” Agrawal said. “We can help members understand their options for care and services and choose the best option specifically for them.”

This connection to members’ individual needs was recognized with a Person-Centered Organization designation for Elevance Health-affiliated Medicaid plans in 12 states that offer long-term services and supports (LTSS). The approach helps teams provide a person-centered, individual goal-focused, data-driven, coordinated care strategy that maximizes independence, impact and value, driving measurable improvements in affordability and quality of care.

When Lilliana was pregnant with her son Xavier and noticed a lump on her neck, she reached out to her Elevance Health-affiliated plan. Her health plan’s care manager helped Lilliana understand the scope of her benefits and worked with Lilliana’s doctors to help her get a biopsy. The care manager also went a step further to address some of Lilliana’s additional concerns by reaching out to community organizations to help the expectant mom with access to nutritious food, diapers, and other baby supplies.

Expanding Partnerships Into New Areas

Elevance Health and its affiliated health plans invest in community relationships that more broadly support whole health, rather than focusing solely on health partnerships within the existing health system. Today’s health plan leverages data to understand what’s most affecting health in a given community; this may include working with schools to stock on-site food pantries for students and their families or supporting local markets to add the equipment to stock additional nutritious food items that reflect the community’s culture. “Actions like these simultaneously help the community and the individual,” Agrawal said. “They supplement the dedication of care providers and community leaders.”

Elevance Health collaborates with communities across the country so all people can be as healthy as possible. These efforts include hundreds of thousands of volunteer hours and a wide variety of supported events and programs; two examples include building out a robust community garden that’s an on-the-ground opportunity for nutrition education and providing funding and volunteers to transform a local middle school’s weight room.

As health plans continue to evolve, Elevance Health and its affiliated plans demonstrate how taking a broader, more integrated view of health can begin to transform the member experience and strengthen community well-being. By combining data-driven insights, personalized support, and deep partnerships with care providers and local organizations, today’s health plans can help simplify a historically complex system and keep a focus on members. This holistic approach not only supports individuals to navigate their care with greater confidence, but also drives measurable improvements in outcomes, affordability, and overall well-being.

About Elevance Health

Elevance Health is a lifetime, trusted health partner whose purpose is to improve the health of humanity. The company supports consumers, families, and communities across the entire healthcare journey – connecting them to the care, support, and resources they need to lead better lives. Elevance Health’s companies serve over 109 million consumers through a diverse portfolio of industry-leading medical, pharmacy, behavioral, clinical, home health, and complex care solutions. For more information, please visit www.elevancehealth.com or follow us @ElevanceHealth on X and Elevance Health on LinkedIn.