Anthem Blue Cross Blue Shield Inc.’s Strategic Analysis


Strategic planning is crucial for any healthcare organization as it allows analyzing the environment and various factors (such as structure, culture, and design) that contribute to successful operations and reaching tactical goals. The establishment chosen for this analysis is Anthem Blue Cross, in particular, its division dedicated to telehealth – Blue Shield. The approach aims to utilize modern technology to ensure better patient experience by connecting people with medical professionals through smartphones or laptops.

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Thus, having a successful telehealth division is particularly essential for a contemporary healthcare provider as it presents easier access to care (by illuminating the necessity to wait in lines, or by giving exposure to high-quality medical advice in rural areas). This paper aims to examine Anthem Blue Cross Blue Shield and identify the organization’s structure and environment (both internal and external) for future enhancements of operations.

Strategic Analysis

Anthem Blue Cross Blue Shield operates in a relatively new division of healthcare services – telehealth, which can be an excellent opportunity for the development of the company. The current times involve transformation and changes in the industry, thus making it challenging for companies to analyze the environment correctly and plan future operations (American Hospital Association, 2018). However, these organizations should be in control of their development to ensure that patients receive the best care services.

Thus, the Anthem Blue Cross should identify the common trends that are present in the current external environment to create a strategic plan. For this analysis, the PEST model is utilized as it allows determining how different factors influence a particular business model. According to Post (2018), the method involves assessing “political, economic, social, and technological” components (para. 2). The approach can provide valuable insight into the external environment and its structural features.

Firstly, the external environment includes legislative changes that are currently happening in the U.S. in regards to the healthcare system. The Affordable Care Act presents new regulations that apply to patients, healthcare providers, and medical education facilities (“Read the Affordable Care Act,” n.d.). This law initiative is a challenge for health care providers, as they need to adjust their services to comply with new rules. According to Hegwer (2014), organizations have to recruit data analytics to help control costs and integrate new approaches to operations. Besides, it is an economic challenge as cost reduction is required while the services should be adjusted to provide better patient care. Thus, the aim is to make healthcare organizations more efficient financially while enhancing quality.

Social factors include socioeconomic aspects of an industry and its consumers. Telehealth is aimed at lowering costs while providing high-quality services to people (Anthem Blue Cross, 2014). Additionally, it allows providing medical care to patients regardless of their location and making healthcare accessible to rural populations. Thus, the social factors can be considered a strength of the Anthem Blue Cross Blue Shield program as the environment provides opportunities for development in this segment of the industry by delivering services to low income and distant patients that otherwise would be omitted.

Technological advancements present another aspect of environmental factors that affect telehealth. The American Hospital Association (2018) states that “advances in science, technology and information management; new models of care; changes in consumer preferences; and the growth of chronic conditions” are among the most significant challenges that healthcare providers have to face. However, the approach of telehealth to health care services is based on a variety of technical developments (such as the internet, video chat, smartphones, and others). Thus, the evolvement of the current technologies can offer new opportunities to Anthem Blue Shield.

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A variety of internal factors influences the strategic management of Anthem Blue Cross Blue Shield. Firstly, the “Anthem Blue Cross’ Telehealth Program is based on an innovative Open Access Network Model” (Anthem Blue Cross, 2014, p. 9). This management approach allows the organization to control the cooperation between its branches effectively. Secondly, the business strategy of the company involves creating excellent healthcare value for patients and capitalizing on new opportunities of the industry (“Business Strategy”, n.d.).

It aligns with the previously mentioned opportunities that the current external environment presents (technological advancements and legislative initiatives). The vision, mission, and purpose of the organization are to transform health care in the U.S. (“Purpose, vision, and values”, n.d.). It indicates that Anthem Blue Cross’s management strategy is directed at enhancements and development of the current operations.

Finally, the healthcare industry is experiencing difficulties due to a lack of professionals. According to the American Hospitals Association (2018), healthcare providers are inconvenienced by having an insufficient number of nurses and physicians in their facilities.

The trend will continue in the future; thus, having an appointment with a doctor will be difficult for patients. Therefore, Anthem Blue Cross Blue Shield may have trouble with recruiting and retaining medical staff for the organization. Telehealth and modern technology applied by Anthem Blue Cross can transform this challenge into an opportunity. Through video consultation and advanced mechanisms that help store a patient’s information, a medical professional can provide more consultations to people; therefore, a smaller number of medical personnel will be required.

It can be argued that the competition in the telehealth field will be increasing as the industry presents a modern outlook on the development of health services. According to Hegwer (2014), contemporary health care is inseparable from technology, as more hospitals utilize data analysis to identify weaknesses and opportunities for improvement. Telehealth presents an ideal solution for many of the challenges of the modern healthcare business (such as cost reduction). Thus, one can predict that the majority of organizations in the U.S. will implement telehealth programs similar to the one offered by Anthem Blue Cross. Therefore, competition within the industry will be increasing within the next years.

There are a few areas of uncertainty that can influence the strategic plan for Anthem Blue Cross. The financial aspect of telehealth and its provision is unclear. Thus, the need to further invest in technological development can be challenging. Data that would indicate the amount of money that the company has spent on the telehealth program can provide insight into the issue. Additionally, according to Kaplan and Norton (1993), new strategic goals require an adjustment in financial scorecards. Thus, new indicators should be developed that would account for the current challenges and opportunities within the industry.


Overall, Anthem Blue Cross Blue Shield operates in a challenging environment due to changes in healthcare organizations’ business approaches. The PEST analysis indicates that political and economic climate present challenges to the company, while social and technological aspects provide opportunities. Also, the internal environment of Anthem Blue Cross is managed in a manner that advocates for a necessity of transformational changes both within an industry and in the company. Thus, it is an opportunity that the healthcare provider can utilize in its strategic plan.

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American Hospital Association. (2018). 2018 environmental scan. Web.

Anthem Blue Cross. (2014). Anthem Blue Cross telehealth program – provider manual. Web.

Business strategy. (n.d.). Web.

Hegwer, L. R. (2014). Digging deeper into data. Healthcare Financial Management, 68(2), 80-84.

Kaplan, R. S., & Norton, D. P. (1993). Putting the balanced scorecard to work. Harvard Business Review, 71(5), 134-147.

Post, J. (2018). What is a PEST analysis? Business News Daily. Web.

Purpose, vision, and values. (n.d.). Web.

Read the Affordable Care Act. (n.d.). Web.

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