Blue Cross Blue Shield Plan News Roundup: September 2023

Anthem Blue Cross and Blue Shield in Connecticut announced its Anthem Link Virtual First health plans to eligible members in select commercial health plans. Anthem Link Virtual First plans give individuals affordable access to virtual care options, including access to a symptom checker driven by artificial intelligence, routine wellness care, and chronic condition management, along with behavioral healthcare.


Blue Cross of Idaho, the state’s largest health insurer, is encouraging Idahoans who may have lost Medicaid coverage to take advantage of an extended special enrollment period to purchase a qualified health plan. The special enrollment period ends on November 30, 2023, and once enrolled in coverage for 2023, coverage for 2024 is automatically renewed.


Blue Cross Blue Shield of Michigan, a national leader in streamlined prior authorization programs, is further reforming its process to relax approximately 20% of prior authorization requirements. This is part of Blue Cross’ ongoing effort to improve health care quality, experience, access and affordability for members, while also reducing administrative tasks for clinicians.


Blue Cross and Blue Shield of North Carolina (Blue Cross NC) announced that the North Carolina Department of Insurance (NCDOI) has approved a 4% average rate decrease for individual customers and families who enroll in Affordable Care Act (ACA) plans in 2024. This average rate decrease will lower total premiums by an estimated $130 million and reflects a Blue Cross NC commitment to creating sustainable health plans that are more affordable for all.


A new, three-year agreement between Blue Cross and Blue Shield of Oklahoma (BCBSOK) and Stillwater Medical was recently finalized keeping them in network through Dec. 31, 2026, for BCBSOK members. The contract keeps Stillwater Medical hospitals in Stillwater, Blackwell and Perry and the doctors and health care professionals employed by Stillwater Medical in BCBSOK networks as well.


Blue Cross and Blue Shield of Texas and Huston-Tillotson University are collaborating on a new program aimed at improving infant and maternal health outcomes by educating doulas and developing training curriculums for midwives and lactation consultants. The goal of the Boldly B.L.U.E. program, which stands for birthing, learning, understanding and empowering, is to increase the number of diverse and culturally-aligned doulas, certified lactation consultants and lay midwives in central Texas.


Blue Shield of California and Salesforce announced an expanded collaboration to meet members’ need for unified experiences by leveraging the agility and breadth of the Salesforce platform. With its adoption of Salesforce Health Cloud, Blue Shield of California will be able to expand and scale more in-depth care management services to its members, promoting higher quality care. Additionally with Salesforce, Blue Shield is bringing together a consistent enrollment experience for employers and brokers to reduce the processing time for benefits administration from 24 hours to just five minutes.


The fight between Bon Secours Mercy Health’s Virginia operations and Anthem Blue Cross Blue Shield escalated after Bon Secours filed a lawsuit against Anthem Blue Cross Blue Shield. In a complaint filed in Henrico Circuit Court, Bon Secours says Anthem has adopted “slow pay and no-pay tactics” in Virginia to avoid reimbursing the system more than $73 million for services in a timely fashion and improperly deny it more than $20 million in reimbursements.


Catholic Health and Empire BlueCross BlueShield announced an agreement focused on new care delivery models designed to lower costs and increase value for people on Long Island. This latest multi-year agreement builds upon the longstanding relationship between the two organizations. Through this innovative partnership, Catholic Health’s payment rates will be connected to improved health outcomes and quality-of-care indicators, reflecting Catholic Health’s ongoing commitment to delivering high-quality care.


Highmark Health announced consolidated financial results for the first six months of 2023, reporting $13.6 billion in revenue, an operating gain of $230 million and net income of $389 million. These results are due to the positive performance of most business units, notably Highmark Health Plans, United Concordia Dental and HM Insurance Group, driven by strong membership as customers chose our plans due to their affordability and care accessibility. Highmark Health’s provider network, Allegheny Health Network (AHN), saw increased patient volumes year-over-year, which boosted revenue. Additionally, the enterprise benefited from the positive equity market performance, as unrealized investment impact added about $200 million to Highmark Health’s total net income.


Takeaway: AMI’s annual Blue Cross Blue Shield Plans Report AMI’s Plans Report provides profiles on each of the 34 BSBS plans as well as the BCBSA organization