Case Study: Blue Cross Blue Shield achieves integrated compliance, risk, and audit management with MetricStream

Blue Cross Blue Shield Affiliates Adopt an Integrated Approach to Intensify Overall Compliance, Risk and Audit Management

Blue Cross Blue Shield (BCBS) affiliates—a federation of 39 independent, community‑based health plans—faced a rapidly expanding and complex regulatory environment (ACA, NAIC MAR, HIPAA, CMS and others). Manual spreadsheets, email‑based tracking and siloed processes made it hard to keep up with hundreds of requirements, increased the risk of noncompliance and created duplication, inefficiency and limited visibility across organizations.

MetricStream was chosen to deliver an integrated GRC platform that centralized regulatory alerts, policy and audit management, risk and issue tracking, market conduct and accreditation workflows and ERP integration. The deployment automated manual processes, provided a single compliance library and real‑time dashboards, and delivered demonstrable results: end‑to‑end compliance with key mandates (including NAIC MAR and CMS), stronger control monitoring, faster remediation, improved operational efficiency and measurable cost savings.

Blue Cross Blue Shield