Blue Cross Blue Shield of Massachusetts: Difference between revisions
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{{Infobox company |
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| name = Blue Cross Blue Shield of Massachusetts |
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| logo = |
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| caption = Blue Cross Blue Shield of Massachusetts |
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| genre = <!-- Only used with media and publishing companies --> |
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| fate = |
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| predecessor = |
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| foundation = <!-- {{Start date|YYYY|MM|DD}} --> |
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| founder = |
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| defunct = <!-- {{End date|YYYY|MM|DD}} --> |
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| location_city = Boston |
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| location_country = |
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| location = |
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| locations = |
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| area_served = Massachusetts |
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| key_people = Andrew Dreyfus (CEO)</br> William C. Van Faasen (Chairman)<ref name="Facts"/> |
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| industry = [[Medical industry]] |
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| products = [[Health insurance]] |
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| services = |
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| revenue = $6.3 billion (2010)<ref name="2010 Financials">{{cite web |url=http://www.bluecrossma.com/visitor/annual-report/our-financials.html |title=Financials |publisher=Blue Cross Blue Shield of Massachusetts |accessdate=November 5, 2011}}</ref> |
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| aum = <!-- Only used with financial services companies --> |
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| assets = |
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| owner = |
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| num_employees = ~3,600<ref name="Facts">{{cite web |url=http://www.bluecrossma.com/visitor/about-us/just-facts.html |title=Just the Facts: Blue Cross Blue Shield of Massachusetts |publisher=BCBSMA |accessdate=November 6, 2011}}</ref> |
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| parent = [[Blue Cross Blue Shield Association]] |
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| divisions = |
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| subsid = |
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| homepage = <!-- {{URL|www.example.com}} --> |
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}} |
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'''Blue Cross Blue Shield of Massachusetts''' ('''BCBSMA''') is an state licensed private [[health insurance]] company under the [[Blue Cross Blue Shield Association]] with headquarters in [[Boston]]. |
'''Blue Cross Blue Shield of Massachusetts''' ('''BCBSMA''') is an state licensed private [[health insurance]] company under the [[Blue Cross Blue Shield Association]] with headquarters in [[Boston]]. |
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==Workings== |
==Workings== |
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BCMSMA formed in 1998 after the merger of [[Blue Cross]] and Blue Shield of Massachusetts.<ref name="Our History">{{cite web |url=http://www.bluecrossma.com/visitor/about-us/our-history.html |title=Our History: Blue Cross Blue Shield of Massachusetts |publisher=BCBSMA |accessdate=November 6, 2011}}</ref> In 1992 they offered an [[HMO]] plan along with the rise of [[managed care]] in the 1990s.<ref name="Our History"/> |
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BCBSMA has [[non-profit]] status as a health insurer<ref name="Review"/> and has 2.8 million policyholders, the largest of any insurer in [[Massachusetts]], with most of them [[Employer-sponsored health insurance|insured through employers]].<ref name="Refunds">{{cite news |title=After a rich severance deal, insurer issues refunds |author=Robert Weisman |newspaper=[[Boston Globe]] |date=October 21, 2011 |url=http://articles.boston.com/2011-10-21/business/30306873_1_individual-policyholders-blue-cross-blue-shield-refunds |accessdate=October 31, 2011}}</ref> The number of policyholders dropped slightly in between the first and second quarters of 2011, due to the [[Economy of the United States|economy]] and layoffs.<ref>{{cite news |title=Health insurers post surpluses – One of reasons cited: Lower patient demand for services |author=Lisa Eckelbecker |newspaper=[[Telegram & Gazette]] |date=August 16, 2011 |url=http://www.telegram.com/article/20110816/NEWS/108169981/1002/RSS01&source=rss |accessdate=October 31, 2011}}</ref> The organization's compensation for their outgoing CEO, [[Cleve Killingsworth]], totaled $8.6 million in 2010; when it was reported in 2011, public anger and a four month investigation from the [[Massachusetts Attorney General]] followed.<ref name="Review">{{cite news |title=AG to review exit pay for Blue Cross executive |author=Robert Weisman |newspaper=[[Boston Globe]] |date=March 3, 2011 |url=http://articles.boston.com/2011-03-03/business/29342010_1_severance-blue-cross-blue-shield-employment-contract |page=5 |accessdate=October 31, 2011}}</ref><ref name="Refunds"/> BCBSMA ultimately credited $4.2 million, representing Killingsworth's severance, off of policyholder's premiums (~$3 per policyholder).<ref name="Refunds"/> |
BCBSMA has [[non-profit]] status as a health insurer<ref name="Review"/> and has 2.8 million policyholders, the largest of any insurer in [[Massachusetts]], with most of them [[Employer-sponsored health insurance|insured through employers]].<ref name="Refunds">{{cite news |title=After a rich severance deal, insurer issues refunds |author=Robert Weisman |newspaper=[[Boston Globe]] |date=October 21, 2011 |url=http://articles.boston.com/2011-10-21/business/30306873_1_individual-policyholders-blue-cross-blue-shield-refunds |accessdate=October 31, 2011}}</ref> The number of policyholders dropped slightly in between the first and second quarters of 2011, due to the [[Economy of the United States|economy]] and layoffs.<ref>{{cite news |title=Health insurers post surpluses – One of reasons cited: Lower patient demand for services |author=Lisa Eckelbecker |newspaper=[[Telegram & Gazette]] |date=August 16, 2011 |url=http://www.telegram.com/article/20110816/NEWS/108169981/1002/RSS01&source=rss |accessdate=October 31, 2011}}</ref> The organization's compensation for their outgoing CEO, [[Cleve Killingsworth]], totaled $8.6 million in 2010; when it was reported in 2011, public anger and a four month investigation from the [[Massachusetts Attorney General]] followed.<ref name="Review">{{cite news |title=AG to review exit pay for Blue Cross executive |author=Robert Weisman |newspaper=[[Boston Globe]] |date=March 3, 2011 |url=http://articles.boston.com/2011-03-03/business/29342010_1_severance-blue-cross-blue-shield-employment-contract |page=5 |accessdate=October 31, 2011}}</ref><ref name="Refunds"/> BCBSMA ultimately credited $4.2 million, representing Killingsworth's severance, off of policyholder's premiums (~$3 per policyholder).<ref name="Refunds"/> |
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Revision as of 22:07, 6 November 2011
| Industry | Medical industry |
|---|---|
| Founded | 1988  |
| Headquarters | Boston |
Area served | Massachusetts |
Key people | Andrew Dreyfus (CEO) William C. Van Faasen (Chairman)[1] |
| Products | Health insurance |
| Revenue | $6.3 billion (2010)[2] |
Number of employees | ~3,600[1] |
| Parent | Blue Cross Blue Shield Association |
| Website | www |
Blue Cross Blue Shield of Massachusetts (BCBSMA) is an state licensed private health insurance company under the Blue Cross Blue Shield Association with headquarters in Boston.
Workings
BCMSMA formed in 1998 after the merger of Blue Cross and Blue Shield of Massachusetts.[3] In 1992 they offered an HMO plan along with the rise of managed care in the 1990s.[3]
BCBSMA has non-profit status as a health insurer[4] and has 2.8 million policyholders, the largest of any insurer in Massachusetts, with most of them insured through employers.[5] The number of policyholders dropped slightly in between the first and second quarters of 2011, due to the economy and layoffs.[6] The organization's compensation for their outgoing CEO, Cleve Killingsworth, totaled $8.6 million in 2010; when it was reported in 2011, public anger and a four month investigation from the Massachusetts Attorney General followed.[4][5] BCBSMA ultimately credited $4.2 million, representing Killingsworth's severance, off of policyholder's premiums (~$3 per policyholder).[5]
Alternative quality contracts and reform
The company has received praise for its alternative quality contract (AQC) payment model.[7] In 2007, then CEO Cleve Killingsworth set a 6 month deadline for the company to come up with a new payment plan to offer health care providers.[8] Killingsworth thought existing pay for performance initiatives were insufficient to prevent billions of dollars in wasteful health care spending that either harmed or did not help patients.[8] AQCs were established in January 2009[9] and they serve as a model for global payments—in contrast to the fee-for-service model, which encourages excessive treatments—in the state.[10] AQCs were envisioned as a way to increase provider accountability, and they are based off of capitation with a bonus for patient quality outcomes to serve as a disincentive against providers neglecting patients.[8] The word capitation was discouraged during company meetings, as it proved unpopular with providers under the managed care of the 1990s.[8] AQCs "pays groups of doctors and hospitals a set fee to work as a team in caring for patients" and as of October 2011 "the plans cover about 613,000 people, or roughly two-thirds of Blue Cross members in health maintenance organizations, but none of those in preferred provider organizations."[10]
When the company was introducing AQCs to providers, "state lawmakers started talking about payment reform", leading to unexpected interest.[8] Deb Devaux, an executive, said providers also wanted to demonstrate willingness towards reform.[8] In 2011, the large provider group Partners HealthCare joined the AQC, accepting lower than expected payment levels, possibly preempting regulatory moves to control costs.[10]
See also
References
- ^ a b "Just the Facts: Blue Cross Blue Shield of Massachusetts". BCBSMA. Retrieved November 6, 2011.
- ^ "Financials". Blue Cross Blue Shield of Massachusetts. Retrieved November 5, 2011.
- ^ a b "Our History: Blue Cross Blue Shield of Massachusetts". BCBSMA. Retrieved November 6, 2011.
- ^ a b Robert Weisman (March 3, 2011). "AG to review exit pay for Blue Cross executive". Boston Globe. p. 5. Retrieved October 31, 2011.
- ^ a b c Robert Weisman (October 21, 2011). "After a rich severance deal, insurer issues refunds". Boston Globe. Retrieved October 31, 2011.
- ^ Lisa Eckelbecker (August 16, 2011). "Health insurers post surpluses – One of reasons cited: Lower patient demand for services". Telegram & Gazette. Retrieved October 31, 2011.
- ^ Enthoven AC (2011). "Reforming Medicare by reforming incentives". N. Engl. J. Med. 364 (21): e44. doi:10.1056/NEJMp1104427. PMID 21561341.
{{cite journal}}: Unknown parameter|month=ignored (help) - ^ a b c d e f Anonymous (2011). "An insurer adds a new twist to an old idea". Health Aff (Millwood). 30 (1): 62. doi:10.1377/hlthaff.2010.1199. PMID 21209438.
{{cite journal}}: Unknown parameter|month=ignored (help) - ^ Chernew ME, Mechanic RE, Landon BE, Safran DG (2011). "Private-payer innovation in Massachusetts: the 'alternative quality contract'". Health Aff (Millwood). 30 (1): 51–61. doi:10.1377/hlthaff.2010.0980. PMID 21209437.
{{cite journal}}: Unknown parameter|month=ignored (help)CS1 maint: multiple names: authors list (link) - ^ a b c Abby Goodnough and Kevin Sack (October 17, 2011). "Massachusetts Tries to Rein In Its Health Costs". The New York Times. Retrieved October 28, 2011.