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Related Experiment Videos

Not your father's Blue Cross/Blue Shield.

L Kertesz

    Modern Healthcare
    |October 14, 1996
    PubMed
    Summary

    The Blue Cross and Blue Shield plans are actively adapting to managed care. These independent health insurance providers are merging and restructuring to stay competitive in diverse markets.

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    Area of Science:

    • Health Services Research
    • Managed Care Organizations
    • Healthcare Economics

    Background:

    • The US healthcare system features 62 independent Blue Cross and Blue Shield (BCBS) plans.
    • These BCBS plans collectively serve 66.3 million individuals across varied market landscapes.
    • The current managed-care environment presents significant competitive challenges for these independent plans.

    Purpose of the Study:

    • To analyze the adaptive strategies employed by Blue Cross and Blue Shield plans.
    • To understand the transformations occurring within the BCBS system in response to market pressures.
    • To highlight the evolving nature of these long-standing health insurance providers.

    Main Methods:

    • Qualitative analysis of industry trends and strategic initiatives.
    • Review of market dynamics affecting independent health insurance providers.
    • Examination of structural changes within the Blue Cross and Blue Shield network.

    Main Results:

    • Blue Cross and Blue Shield plans are exhibiting significant strategic activity.
    • Common strategies include mergers, formation of consortia, and creation of for-profit subsidiaries.
    • Conversion to for-profit status is a notable trend among these plans.

    Conclusions:

    • The Blue Cross and Blue Shield landscape is undergoing substantial transformation.
    • These plans are actively restructuring to enhance competitiveness within the managed-care sector.
    • The operational and structural models of BCBS plans are diverging significantly from historical norms.

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