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Choosing among health insurance options: a study of new employees.

This study examines how 296 new university employees selected among alternative health care options. Those selecting a traditional Blue Cross and Blue Shield (BC&BS) plan attributed greater importance to freedom of choice of physician, while those selecting an HMO were more likely to give priority to cost considerations in seeing a doctor and to having services at a single location. Better educated respondents and those with more recent experience with the medical care system were more accurate in objectively appraising alternative choices. Respondents, whether choosing a BC&BS plan or an HMO, tended to deny the gatekeeper roles of physicians in HMOs, although the BC&BS plan enrollees were somewhat better informed.

Attitude↗

Insurance effects on employer group dental expenditures.

As the number of dental insureds and the amount of insured expenditures have increased over the past decade, so has interest in determining insurance effects on dental demand among employer groups and their insureds. Using Pennsylvania Blue Shield (PBS) employer group data representing 50-65% of all PBS insureds, the authors estimate the own-effect of basic insurance rates (diagnostic, preventive, restorative, endodontic, extraction services) and the cross-effects of riders A (crowns and oral surgery), B (prosthodontics), C (periodontics), and D (orthodontics) insurance rates on annual basic expenditures for 1975-1979. Results indicate a consistently positive relationship between basic insurance rates and expenditures. Orthodontic insurance rates have positive cross-effects on basic expenditures, suggesting basic-orthodontic complementarities. Although not statistically significant, potential substitution relationships may exist between basic and oral surgery, prosthodontic, and periodontic services. The implications of these findings for plan design and public oral health are discussed.

Blue Cross Blue Shield Insurance Plans↗

The changing Blue Cross-provider relationship.

Several forces in the healthcare marketplace are causing profound changes in the historic relationship between Blue Cross and Blue Shield plans and healthcare providers. In light of the fact that the Blues still have the largest share of the private health insurance market, it is important for healthcare providers to understand the significance of these changes and where relationships with the Blues may be headed in the future. In this article, I will analyze the development of Blue Cross provider relationships, the forces currently at work in the marketplace and the changes they are causing. I will use a recent case study to illustrate how these changes are leading to outright hostility between the Blues and providers.

Blue Cross Blue Shield Insurance Plans↗