Case Study: Major BlueCross BlueShield Health Insurance Provider achieves superior compliance, audit, and issue management with MetricStream

A Bluecross Blueshield Associate Achieves Superior Compliance, Audit And Issue Management

A large independent non-profit health plan and BlueCross BlueShield affiliate serving millions of members faced mounting regulatory pressure from HIPAA, Medicare/Medicaid and healthcare reform. Its fragmented, in‑house systems could not integrate policy, audit and issue processes across departments, causing repetitive work, low productivity and difficulty keeping pace with changing compliance requirements.

MetricStream deployed a centralized GRC platform—covering compliance, audit, issue, and policy management—with role‑based portals, automated workflows, alerts and robust reporting for several thousand users. The solution eliminated duplicate processes, improved transparency and tracking, streamlined remediation and audit workflows, and materially increased enterprise efficiency and compliance oversight.