Blue Cross Blue Shield Plan Financial & Activities News: April 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 33 BSBS plans as well as the BCBSA organization.


Ballad Health and Anthem Blue Cross and Blue Shield in Virginia have signed a new multiyear agreement with the health system’s hospitals, facilities, and physicians in Anthem’s network in Virginia guaranteeing continued access for Anthem members in the Commonwealth. Ballad Health is an integrated community health improvement organization serving 29 counties of the Appalachian Highlands in Northeast Tennessee, Southwest Virginia, Northwest North Carolina, and Southeast Kentucky. The agreement includes plans to expand digital connectivity between the two organizations that will simplify system requirements and streamline processes that ultimately improve patient/member experiences and outcomes.


Piedmont and Anthem Blue Cross and Blue Shield in Georgia have reached a new multi-year agreement that was effective April 1, 2024, that extends the partnership providing access to quality care for the more than 400,000 members they mutually serve. Piedmont is a Georgia-based healthcare system with 24 hospitals, 1,755 locations, and 3,200 providers in its Clinically-Integrated Network. The multi-year alliance impacts over 400,000 Georgia Anthem members in six Georgia regions, including metro Atlanta, Athens, Augusta, Columbus, Macon, and Rome (Cartersville). The new agreement applies to Anthem Blue Cross and Blue Shield members enrolled in employer-based, Health Insurance Exchange, and Medicare Advantage plans.


Blue Cross Blue Shield Association and its Michigan affiliate must face a lawsuit from Ford Motor accusing them of artificially inflating the automaker’s costs for health insurance, a U.S. judge has ruled. U.S. District Judge Linda Parker in a ruling, in Detroit federal court said Ford had adequately alleged for now that it was overcharged for commercial health insurance products purchased from Blue Cross. Ford last year alleged Blue Cross organizations violated antitrust law by conspiring to fix prices and not compete with each other, depriving the Detroit-based manufacturer of “the opportunity to purchase health insurance products and services from a lower cost competitor and/or at a price set by the free market.” The judge said Ford could pursue claims over higher premiums from the purchase of health insurance and higher costs for an “administrative services only” product. The judge’s ruling narrowed the scope of Ford’s allegations based on its purchase of administrative services from Blue Cross.


Blue Cross & Blue Shield of Rhode Island (BCBSRI) reported an operating loss of $26 million in 2023, reflecting a substantial surge in medical and pharmacy claims that resulted in costs growing by $195 million, or 10.5%, over the prior year. Through administrative cost reductions and the positive performance of the plan’s investment portfolio, BCBSRI delivered a slightly better than break-even net gain of $602,000 on a margin of 0.1% of revenue for the calendar year ending Dec. 31. BCBSRI’s medical enrollment grew by 2.3% in 2023 to now cover more than 431,000 members – approximately 10,000 more than year-end 2022.


The Purchaser Business Group on Health (PBGH), a membership organization of 40 of the country’s largest private employers and public entities, announced the launch of PBGH’s groundbreaking Care Excellence Program in California. Designed to establish a gold standard in health care, this innovative program rigorously evaluates and identifies top-tier advanced primary care teams based on an employer and purchaser set of standards and shared quality metrics. The Care Excellence Program aims to make it easier for employers and purchasers to identify and collaborate with the highest quality clinicians in any region. Blue Shield of California, recognizing the potential of the Care Excellence Program to set a new benchmark in health care quality and accessibility, is collaborating with PBGH to implement market testing and early adoption of the program.


Just one year after Blue Shield of California launched Virtual Blue as an option for employers, the innovative new health benefit plan is already delivering on its promise to provide convenient access to high-quality integrated primary, specialty, mental health and behavioral health care. Members who used virtual care experienced shorter appointment wait times, fewer emergency room visits* and higher primary care engagement.* In post-visit surveys, Virtual Blue members gave their virtual physicians an average Net Promoter Score (NPS) of 96 through the first year of the plan. NPS is a standard measurement of overall satisfaction.


Elevance Health’s operating revenue was $42.3 billion in the first quarter of 2024, an increase of $0.4 billion, or approximately 1 percent compared to the prior year quarter. This increase was driven by higher premium yields to reflect medical cost trend, and growth in Carelon, including a full quarter of revenue from BioPlus, which closed in February of 2023, partially offset by attrition in Medicaid membership. Operating revenue for Carelon was $12.1 billion in the first quarter of 2024, an increase of $0.6 billion, or 5 percent compared to the prior year quarter. This increase was driven by the launch of new risk-based capabilities in Carelon Services and growth in CarelonRx, including a full quarter of revenue from the acquisition of BioPlus, which closed in February of 2023, and growth in external customers served, partially offset by the impact of Medicaid membership attrition on affiliated revenue streams.


Elevance Health and Clayton, Dubilier & Rice (CD&R) announced an agreement to form a strategic partnership to accelerate innovation in primary care delivery, enhance the healthcare experience, and improve health outcomes. This effort, which will operate across multiple regions of the United States, will bring together certain care delivery and enablement assets of Elevance Health’s Carelon Health and CD&R portfolio companies, apree health and Millennium Physician Group (MPG).


Highmark Health and Allegheny Health Network announced they are making a brand-new $1 billion investment for their flagship academic medical center.  It will go to Allegheny General Hospital’s campus. The plan includes building a new patient tower for the cardiovascular tower as well as a new emergency department. Along with the new ED and cardiovascular tower, as part of a 10-year transformation plan which includes other construction and renovation projects that will extend the Living Health model championed by AHN and Highmark.


Independence Health Group, Inc., (Independence) the parent company of Independence Blue Cross, LLC (IBX), released its financial results for 2023, a preview of the organization’s annual report. The organization reported consolidated revenue of $31.1 billion, up 13.6 percent or $3.7 billion over 2022. When revenues are combined with claims paid on behalf of self-funded employers, Independence had health care funds under management of $42.9 billion in 2023, up from $37.7 billion in 2022.