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The Blues at a crossroads.

The nation's Blue Cross and Blue Shield plans may be facing the greatest challenges in the association's 60-year history with the prospects of radical changes in the nation's healthcare system. The Blues, still the nation's largest insurer despite consolidation and growing competition, are dealing with such thorny issues as negative publicity over the operation of some plans and disputes over public ownership of Blues affiliates.

Bankruptcy↗

The uninsured: Blue Cross and Blue Shield responds through community-based programs.

A voluntary local program to underwrite medical care costs for uninsured children has been developed by Blue Cross of Western Pennsylvania. It offers at no cost routine physician and hospital out-patient care services for children to age 19. It is funded by voluntary contributions from the community and matched by the Blue Cross Plan. This program has enjoyed much success and is being replicated by other Plans.

Adolescent↗

Questions remain unanswered in hospice care movement.

The hospice concept is being implemented in a variety of ways as it develops in the United States. But before the concept becomes firmly established in the community hospital a number of questions must be answered, including reimbursement, standards for quality of care, accreditation, and health planning and regulatory considerations.

Accreditation↗

HMO and PPO growth and hospital utilization and payment: a recursive model.

A recursive model of growth of Blue Cross and Blue Shield Plan Health Maintenance Organization (HMO) and Preferred Provider Organization (PPO) membership share is used to analyze total hospital utilization and payments per thousand insured members over an eight year study period, 1980 through 1987. Results indicate a strong, significant relationship between previous year Plan payments and current year growth in HMO membership share. Additional results suggest that Blue Cross and Blue Shield Plans experienced significant reductions in utilization and payments rates resulting from PPO membership share gains and not from HMO membership share gains.

Blue Cross Blue Shield Insurance Plans↗

Two states, two stories.

Pennsylvania and Tennessee took different paths to publicly reporting hospital quality data. Hospitals elsewhere can learn how such policies should and shouldn't be set up.

Blue Cross Blue Shield Insurance Plans↗

Private industry health insurance plans: type of administration and insurer in 1974.

This report examines the major forms of administration of private health insurance plans. Plans are classified according to whether they are employer-only or joint worker-employer-operated and according to whether they are negotiated or not. A further focus of examination that often reflects industry patterns is whether the plans cover workers of a single employer or involve multi-employer arrangements. These classifications of administration and the method of insuring benefits are examined in terms of proportions of workers with specified plan characteristics and health benefits.

Blue Cross Blue Shield Insurance Plans↗