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PubMed1982

Reductions in insurance for mental disorders: adverse selection, moral hazard, and consumer demand.

Coverage for mental illness has been sharply reduced in the Federal Employees Health Benefits Program (FEHBP), especially in the largest of the participating plans, the Blue Cross and Blue Shield plan. The authors examine the role of adverse selection (accumulation of high-risk consumers within a given plan), moral hazard (demand for services for illness depending in part on the price of the services), and lack of overt consumer demand in the current trend. They point out the critical need for psychiatry to develop more effective approaches to public education on the nature of mental illness and its treatment. If the recent major cutbacks in the FEHBP prevail, this kind of restriction is likely to become the prevailing mode of mental illness coverage under private health insurance.

Blue Cross Blue Shield Insurance Plans↗
PubMed1983

The decline in the Blue Cross Plan admission rate: four explanations.

Between 1968 and 1979, there occurred a steady decrease in the hospital admission rate for Blue Cross Plan members, in contrast to the steady increase in the admission rate for the under-65 U.S. population as a whole. Four general factors were studied to explore the reasons for this relative decrease: utilization control and cost containment activities instituted by Blue Cross Plans, the decline in Plan nongroup membership, duplicate coverage within families, and deficiencies in the family factor technique to estimate overall Plan membership. With some interesting exceptions within one of the factors, all four offer plausible explanations for the decline in the admission rate among Blue Cross Plan members.

Blue Cross Blue Shield Insurance Plans↗
PubMed1982

Antitrust implications of health planning: National Gerimedical Hospital and Gerontology Center v. Blue Cross of Kansas City.

In National Gerimedical Hospital and Gerontology Center v. Blue Cross of Kansas City, the United States Supreme Court held that there is no blanket exemption from antitrust laws for health planning activities. The Court also held that no specific immunity can be granted where the challenged health planning activity is not undertaken pursuant to a federal regulatory scheme. This Comment reviews the Court's decision and concludes that the Court correctly determined that the challenged activities did not qualify for an exemption. The Comment also examines the implications of the Court's statement that, where Congress has manifested a belief that competition is ineffective in the health care industry, application of the antitrust laws should be modified. The Comment recommends that an intermediate review standard such as the "presumptive, incentive modifying approach" should be used by future courts in deciding whether the ineffectiveness of competition in a given area of health planning activity warrants immunity from antitrust scrutiny.

Blue Cross Blue Shield Insurance Plans↗
PubMed2002

They've got the blues. Minnesota Blues and hospitals point fingers regarding who is ultimately responsible for the nation's soaring healthcare costs.

A battle is escalating between hospitals and Blues plans over who is responsible for soaring healthcare costs, and Blue Cross and Blue Shield of Minnesota has launched the latest volley. The insurer recently irritated hospital officials with its report criticizing Minnesota's hospital construction boom. Colleen Reitan (left), senior vice president of the Minnesota Blues, says a financial reality must be faced.

Blue Cross Blue Shield Insurance Plans↗
PubMed1986

Factors related to the use of ambulatory mental health services in three provider plans.

The use of ambulatory mental health (MH) services by adults was studied in three provider plans: Blue Cross (BC), Group Health Cooperative (GHC) and United Healthcare (UHC), an experimental new plan in which a patient's primary care physician managed all of his care. Approximately 8.3% of the enrollees in each plan had some MH use in the 18 months of the study. We studied correlates of MH use (yes/no). Sex was not a significant predictor of MH use. In general, worse health and lower socioeconomic status (SES) were correlated with having at least one MH visit, but better health and higher SES were correlated with a higher quantity of use for those who had some MH use. The three insurance plans did not differ significantly in the proportion of people who had any MH services, but BC users of MH services had 2-3 times more MH visits and higher costs than GHC and UHC users. This suggests that the reliance on primary care providers in UHC and GHC may have changed the nature of MH care as compared to Blue Cross. The effects of income, MH need and symptom sensitivity on MH use were different among the three plans.

Ambulatory Care↗