Blue Cross Blue Shield News Roundup: June 2023

Ford Motor Co. sued Blue Cross Blue Shield Association in U.S. court, accusing it of a price-fixing conspiracy that caused the automaker to pay inflated costs for health insurance products for its employees. The lawsuit Ford filed in Detroit federal court accused the insurer and its regional Michigan branch of unlawfully dividing up parts of the country in a scheme to reduce competition with each other in order to drive “astronomical profits.” The allegations from Ford, employing more than 170,000 workers worldwide, relate to a $2.7 billion settlement that Blue Cross Blue Shield Association and its three dozen member companies reached in 2020 with corporate and individual policy holders in Alabama federal court. Ford opted out of that settlement, which is now on appeal at the Atlanta-based 11th U.S. Circuit Court of Appeals, in order to pursue its own claims. The appeals court agreed to fast-track its consideration of the settlement.

Blue Cross Blue Shield of Arizona (AZ Blue) announced it is expanding its strategy beyond health insurance and toward health solutions. AZ Blue has launched a new company, Prosano Health Solutions, Inc., to become an integral part of improving healthcare for Arizonans. Both AZ Blue and Prosano Health Solutions, Inc. share the same mission: To Inspire Health and Make It Easy. In partnership with stakeholders from Arizona’s communities, clinically-driven expertise, and digitally-supported solutions, AZ Blue has designed and are continuing to create a healthcare experience that customers are asking for—more affordable, personal, and convenient. Prosano Health Solutions, Inc. will improve access to care, reduce waste and complexity, and advance the total healthcare experience for patients and providers. Prosano Health Solutions, Inc. has launched its first Advanced Primary Care Center under the new company with three more Maricopa County locations opening in 2024.  Prosano Health Solutions launched in January of this year for AZ Blue employees, with 1,800 employees and their dependents enrolling. The Advanced Primary Care Centers offer a comprehensive care model, that includes one-stop access to a primary care team, behavioral health practitioners, lab services, same-day appointments, virtual options, and a selection of the most needed prescription medications.

Blue Shield of California announced the appointments of three executive vice presidents and chief marketing officer to support the nonprofit health plan’s ambitious goal of transforming the healthcare system into one that is equitable, accessible, and sustainably affordable for everyone. Chief Information Officer Lisa Davis, General Counsel and Corporate Secretary Hope Scott, and Chief Financial Officer Mike Stuart all have been promoted to executive vice presidents reporting to President and Chief Executive Officer Paul Markovich. The three executives previously held senior vice president titles. Blue Shield also welcomed this week Jigar Shah as senior vice president and chief marketing officer, a role that Jeff Robertson held before his retirement at the end of 2022. Shah will report to Sandra Clarke, executive vice president and chief operating officer.

Empire BlueCross BlueShield, downstate, and Empire BlueCross, upstate, announced the company name will become Anthem Blue Cross and Blue Shield and Anthem Blue Cross, respectively, on January 1, 2024. The company retains the Blue Cross Blue Shield name and remains part of the Blue Cross Blue Shield Association, which offers one in three Americans access to needed healthcare. Empire joined the Anthem family in 2006, and the new name represents the next stage in the company’s journey to combine the trust of the Blue Cross and Blue Shield brand and the national resources and capabilities of its parent company and affiliates. The Anthem companies are trusted leaders in health, operating in 13 states in addition to New York.

Highmark Blue Shield announced that Doylestown Health’s Doylestown Hospital has entered into a Pennsylvania Insurance Department and the Pennsylvania Department of Health approved in-network provider contract with Highmark Inc. on behalf of itself and its affiliate health plans. Doylestown Health joins Temple Health and Penn Medicine as an additional hospital system that has entered into an agreement with Highmark Inc. and its affiliate health plans in Southeast Pennsylvania.

Wellinks, a leading digital healthcare company offering virtual Chronic Obstructive Pulmonary Disease (COPD) services for health plans and value-based care providers, announced an agreement with Highmark BlueCross Blue Shield Delaware to deliver high-quality COPD care to underserved populations in Delaware starting on July 1. With Wellinks, Highmark Blue Cross Blue Shield Delaware members will be able to access empowering and effective COPD care services from the comfort of their own homes. The Wellinks virtual-first approach to pulmonary rehabilitation provides members with exercises and education to improve their lung health and reduce shortness of breath. With personalized support from Wellinks coaches, Highmark Blue Cross Blue Shield Delaware members will identify and achieve goals that will help them better manage and live with COPD.

Blue Cross Blue Shield of Michigan and Blue Care Network are adding new benefits and streamlining plan offerings for people selecting individual health plans during the upcoming 2024 ACA Marketplace open enrollment period. New benefits for 2024 open enrollment include adding Virtual Primary Care to all individual Blue Cross PPO plans and adding a menopause benefit to the Maven Maternity and Family program for all individual Blue Cross PPO and BCN HMO plans.

BlueCross BlueShield of Tennessee (BlueCross) announced a verbal agreement for a multi-year deal with the Methodist Le Bonheur health system, effective June 1.The agreement restores in-network access to care for those who have coverage through an employer or through an individual plan.

Takeaway: Comprehensive business intelligence available on Blue Cross Blue Shield plans in AMI’s 2023-2024 Report