Blue Cross Blue Shield

Politics & Government
8:50 am
Fri September 21, 2012

For-profit insurance companies look forward to a more open marketplace in Michigan

Blue Cross Blue Shield building on Lafayette in Detroit.
Wikipedia

There was another day of hearings yesterday on Governor Rick Snyder’s proposed overhaul of Blue Cross-Blue Shield of Michigan.

Other insurance companies say any reforms should make it easier for them to compete with the Blues.

Other insurers have long complained about their inability to win a bigger piece of Michigan’s insurance marketplace. Blue Cross covers four million Michiganders.

Rick Murdock is with the Michigan Association of Health Plans. It’s an organization of 15 for-profit insurers that compete with Blue Cross.

"There’s no disputing the fact that Blue Cross-Blue Shield has 70 percent of Michigan’s commercial insurance market – a monopoly by any definition," said Murdock.

A Blue Cross representative said the proposal will create more competition, and Blue Cross will, for the first time, pay taxes. But he also said the Blues’ marketplace advantage comes from being a not-for-profit company not focused on maximizing profits, and that would not change under this overhaul.

Health
1:40 pm
Thu September 20, 2012

State Senate committee begins examination of Blue Cross Blue Shield overhaul

Blue Cross Blue Shield would undergo major changes under proposed legislation.
Wikipedia

State Senate hearings began today on a proposed overhaul of Blue Cross Blue Shield of Michigan.

The plan calls for Blue Cross to become a customer-owned not-for-profit corporation that’s regulated just like other insurance companies.

Right now, Blue Cross has to accept all applicants, regardless of their health. Starting in 2014, the Blues’ role as “insurer of last resort” will become unnecessary. Due to the federal healthcare law, insurance companies will no longer be able to reject people because of their health conditions.

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It's Just Politics
2:30 pm
Fri September 14, 2012

A mixed reaction from Republicans over Snyder's Blue Cross Blue Shield overhaul

Governor Snyder announced his proposal for an overhaul of Blue Cross Blue Shield this week in Michigan
Photo courtesy of the Snyder Administration

This week on It's Just Politics it’s all about the Blues. Blue Cross Blue Shield, that is. BCBS is, by far, the state’s largest health insurance company. It’s also a state government creation; created by state law. It has its own law, separate from all other insurance companies because it is Michigan’s “insurer of last resort,” meaning that Blue Cross has to take everyone who applies. Its mission: to make sure everyone who wants or needs health insurance in Michigan can get it.

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Politics & Government
4:24 pm
Thu September 13, 2012

Political Roundup: Proposed changes to Blue Cross-Blue Shield, no love for street lighting

A view of the state capitol building in Lansing, Michigan
Steve Carmody Michigan Radio

On Thursdays we talk Michigan politics with Susan Demas, political analyst for Michigan Information and Research Service, and Ken Sikkema, former Senate Majority Leader and senior policy fellow at Public Sector Consultants.

This week, Governor Snyder proposed changes to how Blue Cross-Blue Shield, the state’s largest health insurance provider, will operate.  Plus, legislation that would help Detroit and other cities provide street lighting seems dead, at least for now.

Politics & Government
8:40 am
Wed September 12, 2012

Commentary: Understanding Blue Cross

Whatever else you think about Governor Rick Snyder, you can’t say he has failed to be bold. He has made or tried to make some stunning changes in the way Michigan works in a little over a year and a half in office. Yesterday, he did it again.

He unveiled a plan to dramatically change the health insurance landscape in Michigan by changing the way Blue Cross/Blue shield does business. He would convert it from its current official status as a charity to a nonprofit mutual company over the next fifteen months.

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week in michigan politics
7:55 am
Wed September 12, 2012

The week in Michigan politics

cnc photos flickr

Every Wednesday Morning Edition host Christina Shockley and Michigan Radio's political analyst Jack Lessenberry talk about the latest in Michigan politics. This week they talk about updates to emergency financial managers in Allen Park and Flint, the future of Belle Isle and the proposed overhaul to Blue Cross Blue Shield of Michigan.

morning news roundup
7:46 am
Wed September 12, 2012

In this morning's state news headlines. . .

User: Brother O'Mara flickr

Snyder proposes Blue Cross overhaul

"Governor Rick Snyder has proposed an overhaul of the rules covering Blue Cross-Blue Shield of Michigan. It calls for Blue Cross to become a customer-owned not-for-profit insurance company. Blue Cross would have to pay taxes adding up to $100 million a year or more, but it would be better able to shield its rate-setting decisions from competitors. One of the biggest changes under the federal law is insurance companies can no longer reject applicants based on their health history. Right now, Blue Cross is the only insurance company in Michigan that has to accept all applicants, regardless of their age or health history.  For-profit insurance companies say they want the overhaul to make it easier for them to challenge Blue Cross’s market dominance," Rick Pluta reports.

The future of Belle Isle

"Gov. Rick Snyder and Detroit Mayor Dave Bing have called a news conference Wednesday on the future of Belle Isle park, a tattered green gem that has been subject of a city-state power struggle. Proposals for a Michigan takeover of the under-maintained 985-acre park have met fierce opposition from some local officials who call it a state power grab. Michigan promises park improvements under an agreement between Snyder and Bing that staved off a state takeover of Detroit, struggling with a chronic budget deficit. The agreement says Belle Isle will operate "as part of a cooperative relationship with Milliken State Park" along the Detroit River," the AP reports.

Veterans' courts

"On the 11th anniversary of the 9/11 terrorist attacks, state lawmakers pushed forward a plan to give veterans a better shot to stay out of jail if they commit a non-violent crime. The state Senate unanimously passed two bills establishing a framework for creating veterans courts. They offer judges the option to send veterans to rehabilitation programs instead of jail. There are a number of similar courts in Michigan already. The measures passed unanimously in the House in May. They now go to Governor Snyder’s desk," Jordan Wyant reports.

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Health Insurance
5:30 pm
Tue September 11, 2012

Proposal would change Blue Cross in Michigan

Michigan Gov. Rick Snyder announces proposed changes to how the state's largest health insurance provider is regulated at a press conference, Tues. Sept. 11. 2012.
Governor Snyder's office State of Michigan

Update 5:30 p.m.

Governor Rick Snyder has proposed an overhaul of the rules covering Blue Cross-Blue Shield of Michigan. Blue Cross would have to pay taxes adding up to $100 million a year or more.

But the company could also make changes to its rates a lot more quickly and easily. That would help it compete for business.
    
Andy Hetzel is a vice president at Blue Cross. He says the new federal health care law is changing the insurance marketplace and Michigan needs to keep up.

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Health
1:15 pm
Thu May 10, 2012

Heart patients should ask more questions

Gabriela Camerotti Flikr

Patients with heart disease should ask their doctors more questions before undergoing elective heart procedures.

That's according to a study by the Center for Healthcare Research and Transformation at the University of Michigan and Blue Cross/Blue Shield.
 
Marianne Udow-Phillips is Director of the Center and lead author of the study.   

She says whether or not Blue Cross/Blue Shield patients in the study underwent elective heart procedures depended more on where they received their care compared to whether or not it may have been the best option.

"We do believe that most of the use of these services is really more driven by physician preferences than patient preferences," said Udow-Phillips. "Patients do need to be more involved; they need to ask more questions of their physicians before they have a catheterization procedure.  There does need to be a better dialogue between physicians and patients."

The overall rate of these procedures have declined by 19-percent between 1997 and 2008.

health care
4:48 pm
Thu February 23, 2012

Holland wins $1.6 million in Blue Cross Blue Shield lawsuit

An Ottawa County Circuit Court judge is ordering Blue Cross Blue Shield to pay the City of Holland $1.6 million. Holland is one of dozens of communities that sued Blue Cross over variable fees charged on insurance claims filed by employees.  The city claims the insurer didn’t tell them about the fees for 17 years.

Blue Cross Blue Shield spokesperson Helen Stojic says the fees were not hidden.“As the lawsuit proceeds to the appellate courts we’re confident that the legal process will result in a finding that our access fee were known to our customers,” Stojic said.

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health
5:04 pm
Fri January 6, 2012

Blues, Beaumont reach settlement, avoid booting HMO patients

Beaumont Health System

Blue Cross-Blue Shield of Michigan has reached a five-year deal with Beaumont Health System that will increase reimbursements to the hospital. It also includes a new performance-based payment model.

The health system had threatened to stop accepting patients covered by the Blues’ HMO, Blue Care Network,  starting next Thursday. 

"It was very unfortunate but the good news is that we’ve rescinded that now, and BCN members will not have gone one day without their services being covered at Beaumont and we think that’s a very positive outcome,"  said Beaumont CFO Nick Vitale.

Officials on both sides say the deal will better coordinate care by establishing programs that avoid unnecessary tests "to make sure that the primary care physicians are speaking to the specialists who are speaking to the hospitals to make sure that if there’s a test performed that it’s only performed once," said BCBSM vice president Sue Barkell.

The five-year contract will boost reimbursements to the hospital. But the two sides would not disclose what the rate increase will be.

Politics
4:41 pm
Fri August 19, 2011

Schuette plans review of Blue Cross Medicaid deal

Blue Cross Blue Shield building on Lafayette in Detroit.
Wikipedia

LANSING, Mich. (AP) - Michigan Attorney General Bill Schuette says his office is reviewing Blue Cross Blue Shield of Michigan's plans for a joint venture involving a Medicaid coverage company.

The Detroit-based Blue Cross and Philadelphia-based Independence Blue Cross are purchasing AmeriHealth Mercy, which has Medicaid managed-care contracts in states including Pennsylvania, Indiana, and South Carolina.

Schuette said Friday he wants the Michigan-based Blue Cross to provide his office with documentation related to the transaction.

Blue Cross officials said they welcome the inquiry and will work with him to clarify questions about the transaction.

The joint venture could provide an opportunity for Blues insurers nationwide to expand into Medicaid coverage just as states are seeking ways to save money in the program and the ranks of Medicaid enrollees is poised to grow.

Science/Medicine
2:54 pm
Tue August 9, 2011

Blue Cross/Blue Shield of Michigan buys Medicaid insurer

Blue Cross/Blue Shield of Michigan is expanding its involvement in Medicaid coverage.  Blue Cross/Blue Shield of Michigan joined a Pennsylvania Blue Cross to buy up a Medicaid health care plan based in Philadelphia.  Amerihealth Mercy ser

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Health Care
4:44 pm
Fri December 3, 2010

Holland to file lawsuit against Blue Cross Blue Shield

Holland is the latest city in Michigan planning to file a lawsuit against Blue Cross Blue Shield over variable fees. The fee is a 13.5% administrative access fee Blue Cross charged the city on any insurance claims filed by employees.  The city claims the insurer didn’t tell them about the fees for 17 years.

Holland Mayor Kurt Dykstra says,

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'Blues' facing anti-trust charge
2:35 pm
Mon October 18, 2010

Blue Cross/Blue Shield accused of hiking Michigan hospital prices

Steve Carmody Michigan Radio

 Federal and state prosecutors are suing Blue Cross/Blue Shield of Michigan.

 The non-profit health insurance company is accused of violating anti-trust laws. 

When Blue Cross/Blue Shield of Michigan negotiates a contract with a hospital, it includes a provision giving it a discounted rate compared to other health insurance companies. 

Blue Cross insists that allows it to provide its members with discounted hospital stays.    But the US Justice Department and Michigan’s Attorney General’s office disagree.

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