PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Blue Cross Blue Shield Insurance Plans”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 37 records · Page 2Linked to original sources
PubMed1976

Private health insurance in 1974: a review of coverage, enrollment, and financial experience.

In 1974, more than three-fourths of the civilian population had substantial economic protection through private health insurance against the costs of hospital and surgical care. Smaller proportions were covered at least in part for other health care costs, usually after payment of deductibles and coinsurance. Consumers got back 87 percent of their premium dollars in the form of benefits. The rise in premium income in 1974 lagged 4 percentage points behind the growth in claims incurred. The result was a net underwriting loss of $359.7 million or 1.3 percent of premium income. Most consumers bought their health insurance protection through insurance companies, although Blue Cross-Blue Shield plans served about two-fifths of the insured population for hospital-associated care. In addition, about 6 percent received health care through independent prepayment and self-insured plans.

Accounting↗
PubMed2002

Getting to no: how Kansas advocates derailed the Anthem steamroller.

A battle royale has taken shape in Kansas about the future of its Blue Cross and Blue Shield plan. This past February, Kansas Insurance Commissioner Kathleen Sebelius rocked the corporate health care establishment by refusing to allow Anthem Insurance Company to buy the state's independent Blue Cross and Blue Shield plan. Then in June, a state judge overturned her decision. Now the case is headed to appeals court, where Sebelius will seek to have her decision reinstated. At the heart of the legal wrangling is the unprecedented manner in which advocates have asserted consumer interests, raising issues that will persist long after the courts hand down a final ruling. States of Health looks at how consumer advocates have responded to the proposed Blues transaction, a process that has strengthened the health consumer voice in Kansas--and offers important lessons for advocates in other states as well.

Blue Cross Blue Shield Insurance Plans↗
PubMed1989

Physician participation in prepayment programs for the uninsured.

The problem of the growing number of uninsured increasingly affects physician practices. In Rochester, New York, a cooperative effort between hospitals, physicians, and the Blue Cross and Blue Shield Plan created an insurance program designed for low income uninsured patients. Modified benefits and subsidies from physicians, hospitals and Blue Cross and Blue Shield brought premiums to levels less than half of the rate for unsubsidized coverage. Steps undertaken in the product's development addressed physician concerns, and ensured physician participation sufficient to meet the needs of the program.

Blue Cross Blue Shield Insurance Plans↗
PubMed1993

Opiate dependency among the subscribers of a New York area private insurance plan.

OBJECTIVE: To estimate the prevalence of opiate use among the subscribers of a large private insurance plan, Empire Blue Cross and Blue Shield (EBCBS). DESIGN: Six and a half million hospital inpatient claims for the period January 1, 1982, through June 30, 1992, were reviewed. Thirty-one thousand eight hundred ten different individuals who had a total of 55,143 hospital admissions with a primary diagnosis of opiate dependency (International Classification of Diseases, Ninth Revision, Clinical Modification 304.0 and 304.7) were identified. In the same period, 17,493 EBCBS subscribers (15,191 male and 2302 female) were identified from hospital admissions data as having acquired immunodeficiency syndrome. These data were cross-matched with the opiate dependency data to estimate the "capture" of opiate users in the EBCBS subscribers with acquired immunodeficiency syndrome and to model the size of the opiate using population in EBCBS. RESULTS: It is estimated that between 1982 and 1992 EBCBS insured approximately 141,000 opiate users, 85,000 of whom are currently insured by EBCBS. CONCLUSION: There is a large population of insured opiate users who may be excluded from the estimates of the overall number of opiate users as insured opiate users are less likely to be counted via contact with government agencies. This suggests that current estimates of the number of opiate users and their social characteristics should be reconsidered.

Acquired Immunodeficiency Syndrome↗
PubMed2000

The stability of health status measurement (SF-36) in a working population.

This study tests the stability of health status measurement (SF-36) in a working population. A total of 4,225 employees from two sectors (one state agency, one private company) enrolled in three health plans at Trigon BlueCross/BlueShield of Virginia. An eight-dimension short-form health survey (SF-36) was first tested on a cross-sectional basis for its validity. Then, a panel study was established to test for the stability of health status instrument over time. Structural equation modeling built on equality constraint conditions was the statistical technique for this study. Data were collected through two-wave mail surveys. Both comprehensive (original eight scales) and parsimonious (revised five scales) models of health status were found fit into the data quite well. Furthermore, the revised parsimonious model was shown highly stable over time. Within a working population aged 18 to 64, people are relatively healthy. Their perception of health issues is reflected mainly on "physical health status," as indicated by physical functionings or role limitations. The high stability of revised health status model warrants the possibility of using a more concise health status instrument for the majority of people in working force.

Adult↗
PubMed2004

For-profit conversion and merger trends among Blue Cross Blue Shield health plans.

Blue Cross and Blue Shield (BCBS) health plans, which insure nearly one in three Americans, historically have operated as local, nonprofit or mutual organizations. However, since the mid-1990s, BCBS plans increasingly have converted to for-profit companies and merged with Blue plans in other states. State insurance regulators, charged with weighing the costs and benefits of conversions and mergers to consumers, often wrestle with the legal complexities of these deals, according to Center for Studying Health System Change (HSC) site visits to 12 nationally representative communities. Although state regulatory scrutiny has slowed the pace of conversions recently, conversion activity is likely to accelerate again as the political and regulatory landscapes shift and plans adapt conversion strategies. The limited evidence available from HSC site visits and conversion proceedings suggests that conversions and mergers have had neither significant negative nor positive effects on consumers.

Blue Cross Blue Shield Insurance Plans↗
PubMedDate not supplied

The best of times and the worst of times: A conversation with Vicky Gregg. Interview by James C Robinson.

Blue Cross and Blue Shield plans have enjoyed enviable financial success, while much of the health care delivery system has faced severe financial strains. The contrast is striking in Tennessee, where BlueCross BlueShield of Tennessee dominates the commercial health insurance market and administers much of the state's Medicaid program, TennCare, while TennCare itself recently dropped hundreds of thousands of enrollees from coverage because of budgetary constraints. CEO Vicky Gregg draws lessons from the TennCare crisis for other states; describes her organization's investment in information technology, pricing policies, and management of new clinical technologies; and explains the continued political popularity of a profitable nonprofit health plan.

Blue Cross Blue Shield Insurance Plans↗
PubMed1988

Vertical restraints among hospitals, physicians and health insurers that raise rivals' costs. A case study of Reazin v. Blue Cross and Blue Shield of Kansas, Inc. and Ocean State Physicians Health Plan, Inc. v. Blue Cross and Blue Shield of Rhode Island.

Two recent district court opinions consider whether affiliations among hospitals, doctors and health insurers--through contract or ownership--violate the antitrust laws. This Article applies a raising rivals' costs framework to the facts of those cases in order to assess whether the practices at issue were unreasonable.

Blue Cross Blue Shield Insurance Plans↗
PubMed1992

Blues plans trying to extract better deals from hospitals.

Stung by recent reports indicating that several health insurance plans sponsored by the Blue Cross and Blue Shield Association may be on the brink of insolvency, some Blues plans are putting the squeeze on hospitals by demanding better prices. The Blues are getting tougher with hospitals because they want to slow the increases in their customers' medical bills.

Bankruptcy↗