Blue Cross Blue Shield Plan News Roundup: January 2024

The following Blue Cross Blue Shield announcements are just a few of the company activities from this month.

 

 

AMI offers continuing market research services to clients on Blue Cross Blue Shield Plans as well as publishing an annual Blue Cross Blue Shield Plans Report that provides comprehensive profiles on each of the 34 BSBS plans as well as the BCBSA organization.

 

Anthem

Trinity Health, one of the nation’s largest health systems, and leading health benefits company Anthem Blue Cross and Anthem Blue Cross and Blue Shield (Anthem) announced a new, multi-year provider network agreement. The agreement secures long-term access to affordable health care for Trinity Health patients covered by Anthem. Trinity Health and Anthem will incorporate Epic Payer Platform into regular operations, a technology that will streamline secure patient data flow between the organizations, bolster operational efficiency, accelerate approval processes, and improve patient outcomes.

St. Mary’s Health Care System and Anthem Blue Cross and Blue Shield of Georgia announced a new, multi-year provider network agreement. The agreement secures long-term access to affordable health care for St. Mary’s Health Care System patients covered by Anthem Blue Cross and Blue Shield of Georgia health plans.

Saint Joseph Health System (SJHS) and Anthem Blue Cross and Blue Shield in Indiana announced a new, multi-year provider network agreement. The agreement secures long-term access to affordable healthcare for St. Joseph patients who are covered by Anthem Blue Cross and Blue Shield health plans.

Mount Carmel Health System and Anthem Blue Cross and Blue Shield in Ohio announced a new, multi-year provider network agreement. The agreement secures long-term access to affordable health care for Mount Carmel patients covered by Anthem Medicare, Medicaid, and employer-sponsored health plans.

The Virginia Chamber of Commerce announced its partnership with Anthem Blue Cross and Blue Shield in Virginia on the WiseChoice Healthcare Alliance. Joined by Governor Glenn Youngkin and key local chamber leaders from across the Commonwealth, President & CEO Barry DuVal made this significant health care announcement. Formed from a 30-year partnership between the Virginia Chamber of Commerce and Anthem Blue Cross and Blue Shield in Virginia, the WiseChoice Healthcare Alliance is designed to help drive healthcare engagement and literacy that will lead to improved long-term health and lower healthcare costs.

 

Blue Cross Blue Shield of Minnesota

The U.S. Department of Labor has brought a lawsuit against Blue Cross and Blue Shield of Minnesota alleging the health insurer wrongly passed along a particular state tax to employer health plans wrongly collecting $66.8 million from self-funded plans. The litigation deals with an assessment widely known in Minnesota as the “provider tax” — a state tax paid by hospitals and clinics. Lawmakers created the tax in 1994 to fund the MinnesotaCare health insurance program for lower-income state residents.

 

Blue Shield of California

Blue Shield of California plans to lay off 165 workers by the end of this month, primarily targeting its Oakland office. The company intends to make these job cuts permanent across various locations in the state by Jan. 31, 2024. According to a notice filed with the state’s Employment Development Department, 49 positions will be eliminated at its headquarters in Alameda County.

 

Elevance Health

Elevance Health’s operating revenue was $42.5 billion in the fourth quarter of 2023, an increase of $2.8 billion, or 7 percent compared to fourth quarter 2022. Operating revenue was $170.2 billion in 2023, an increase of $14.5 billion, or 9 percent. The increase in the quarter and year was driven by higher premium revenue in the Health Benefits segment and growth in pharmacy product revenue in CarelonRx. The benefit expense ratio was 89.2 percent in the fourth quarter, an improvement of 50 basis points compared to fourth quarter 2022, and 87.0 percent for the full year, an improvement of 60 basis points year-over-year.

Elevance Health has filed a lawsuit against the Department of Health and Human Services (HHS), alleging its methodology for determining Medicare Advantage star ratings is unlawful. The payer and its affiliated entities filed the complaint against HHS Secretary Xavier Becerra and CMS Administrator Chiquita Brooks-LaSure in the United States District Court for the District of Columbia. The plaintiffs have stated that the methodology changes violate the Administrative Procedure Act.

Elevance Health announced at the Consumer Electronics Show 2024 that it will launch a first-of-its-kind program that will offer high-quality smartphones with unlimited data, talk, and texting service at no cost to eligible individuals enrolled in some of its affiliated Medicaid health plans. These devices will be preloaded with a customized experience and give individuals access to digital and virtual healthcare tools that they might otherwise not have had.

 

Health Care Services Corporation (HCSC)

HCSC has signed a definitive agreement with The Cigna Group to acquire its Medicare Advantage, Medicare Supplemental Benefits, Medicare Part D and CareAllies businesses. The acquisition will benefit HCSC’s current and future members by enhancing the company’s capabilities and reach, particularly in the growing Medicare segment. Cigna’s Medicare plans currently serve 3.6 million Medicare members, with nearly 600,000 in Medicare Advantage plans, more than 450,000 on Medicare Supplement plans and 2.5 million with Medicare Part D. CareAllies — which serves approximately 450,000 patients — is focused on driving the transition to physician value-based care by partnering with providers to form independent physician associations and accountable care organizations, as well as providing management services to support value-based care arrangements.

HCSC began offering a new Cancer Services and Support program to self-funded employers on Jan. 1, 2024. The program is HCSC’s latest effort focusing on optimal outcomes for members and families facing cancer. To alleviate member burdens and complexities, HCSC’s Cancer Services and Support offers holistic solutions to provide high-quality care and support.

 

Highmark

Cognoa, maker of the first FDA-approved autism diagnostic tool, announced Highmark has signed on as its first commercial payer partner. The tool, Canvas Dx, will now be reimbursed for commercial Highmark members. It aims to enable earlier and more equitable access to diagnosis for children and families without specialists. The tool leverages AI to empower doctors to quickly and accurately diagnose developmental risk without bias, the company claims.

West Virginia Department of Human Services (DoHS), Bureau for Medical Services (BMS), the state agency responsible for the administration of West Virginia’s Medicaid program, has approved the Highmark Health Options West Virginia (HHOWV) application to be a managed care organization option for Medicaid eligible West Virginians. Highmark Health Options West Virginia Blue Cross and Blue Shield-branded health plans will be an option for state Medicaid beneficiaries beginning in June for a July 1, 2024 coverage date.

 

Regence

Idaho’s state government employee health insurance — covering more than 25,000 employees and over 35,000 of their family members — is set to be managed by Regence BlueShield of Idaho this summer, as Idaho change’s insurers for the first time in nearly two decades.

Providence Health & Services and Regence BlueCross BlueShield of Oregon have finalized a contract that will keep Providence in network for patients with Regence insurance. The companies announced an agreement Monday, on the last day of their current contract, after months of negotiations. A failure to reach an agreement could have removed more than 260,000 patients with Regence insurance from the Providence network, according to a statement from the healthcare provider.