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Profile of the Blue Cross and Blue Shield System
The 40 independent and locally operated Blue Cross and Blue Shield Plans and the
Blue Cross and Blue Shield Association (BCBSA) comprise the Blue Cross and Blue
Shield System, the nation's oldest and largest family of health-benefits companies.
Blue Cross and Blue Shield Companies represent the full spectrum of health-care
coverage.
Quick Facts
- With headquarters in Chicago and offices in Washington, D.C., BCBSA has about 850
employees. Member Blue Plans collectively have more than 150,000 employees nationwide,
ranking the Blue System as a group among the 20 largest employers in the United
States.
- Collectively the Blue Cross and Blue Shield System provides health-care coverage
for more than 92 million people — nearly one-third of all Americans —
in all 50 states, the District of Columbia and Puerto Rico. They offer a variety
of insurance products to all segments of the population, including large employer
groups, small businesses and individuals.
- 57.5 million in PPOs
- 13.5 million in traditional, fee-for-service programs
- 16.5 million in health maintenance organizations (HMOs)
- 5.5 million in point-of-service (POS) products
- Nationwide more than 90 percent of hospitals and nearly 80 percent of physicians
contract directly with Blue Cross and Blue Shield Companies.
- Blue Cross and Blue Shield Companies have partnered with the federal government
to process Medicare claims and payments since the program’s inception in 1965.
Today, Blue Medicare contractors handle more of the day-to-day work of paying
Medicare claims than any other companies. In 2003, Blue Cross and Blue Shield
Medicare contractors processed nearly 90 percent of more than 170 million total
claims from hospitals and other provider institutions (Part A) and 72 percent of
the more than 881 million claims from physicians and other healthcare practitioners
(Part B).
- Blue Cross and Blue Shield Plans cover half of all Fortune 500 companies and more
than three-quarters of all Fortune 100 companies
Key Initiatives
- Medicare: Blue Cross and Blue Shield Companies have partnered with
the federal government to process Medicare claims and payments since the program's
inception in 1965. Today Blue Medicare contractors handle more of the day-to-day
work of paying Medicare claims than any other companies. In 2003, Blue Cross and
Blue Shield Medicare contractors processed nearly 90 percent of more than 170 million
total claims from hospitals and other provider institutions (Part A) and 72 percent
of the more than 881 million claims from physicians and other health-care practitioners
(Part B).
- FEP: The Blue Cross and Blue Shield System's Federal Employee Program
(FEP) — the largest privately underwritten health insurance contract in the
world — enrolls more than 4.4 million federal government employees, dependents
and retirees. Approximately 52 percent of all federal employees and retirees who
receive their health care through the government's Federal Employee Health Benefits
Program are members of FEP.
- BCBSA's BlueCard® Program — which links participating health-care
providers and the independent Blue Plans across the country through a single electronic
network for claims processing and reimbursement — enables Blue Plans to serve
large national employers, such as Microsoft Corporation, Xerox, United Airlines,
UPS and Wal-Mart.
- In 2004, BlueCard processed more than 162 million claim transactions, up from 132
million in 2003. The vast majority of BlueCard claim transactions represent national
account business, with an increasing percentage moving into PPO.
- To find a BlueCard health-care provider anywhere from coast to coast and to view
a map with detailed driving instructions
visit the BlueCard Provider Finder.
- BlueCard Worldwide®, an international hospital network, expanded
the Blue Brand around the world in 2000 to include providers in more than 200 countries
and territories. Members can now access inpatient and outpatient services throughout
the world — at no additional cost.
- BCBSHealthIssues.com is the Association's online public affairs
resource, providing Blue Cross and Blue Shield Member Plans, health-care opinion
leaders and engaged consumers with balanced, credible information about health-care
issues. The site explores a wide range of issues, including costs, prescription
drugs, association health plans and medical liability reform.
Research and new reports are continually offered on the site from BCBSA as well
as from other organizations across the political spectrum. The site also offers
a suite of e-newsletters with extensive customization options — enabling users
to track debate on specific issues.
- BCBSA's Technology Evaluation Center (TEC) pioneered the
development of scientific criteria for assessing medical technologies through comprehensive
reviews of clinical evidence. TEC assessments provide objective information to those
who deliver and manage medical care. They are based on clinical and scientific evidence
and evaluate whether a technology improves health outcomes.
- In 1997, BCBSA's TEC became an Evidence-based Practice Center and was awarded a
five-year contract by the Federal Agency for Healthcare Research and Quality to
serve as one of the 13 current Evidence-based Practice Centers.
- To date, TEC has completed more than 300 assessments and eight evidence reports.
Blue Cross Roots
- In 1929, Justin Ford Kimball, an official at Baylor University in Dallas, introduced
a plan to guarantee school teachers 21 days of hospital care for $6 per year. Other
groups of employees in Dallas soon joined the plan, and the idea quickly attracted
nationwide attention. In 1933, E. A. van Steenwyk, an executive with the forerunner
of Blue Cross and Blue Shield of Minnesota, began to identify his hospital care
program with a blue-colored cross design. Other groups elsewhere in the country
followed suit,
and by 1939, the Blue Cross symbol was officially adopted by a
commission of the American Hospital Association (AHA) as the national emblem for
Plans that met certain guidelines.
- In 1960, the commission was replaced with the Blue Cross Association, which was independent of the AHA. All formal
ties with the AHA were severed in 1972. At that time, the design of the national Blue Cross symbol was revised,
and a human figure was placed in the center to represent the role of the Plans
in serving human need. The stylized figure is based on Leonardo DaVinci’s “Vitruvian Man.”
Blue Shield Roots
- The Blue Shield concept grew out of the lumber and mining camps of the Pacific Northwest
at the turn of the century. Employers wanted to provide medical care for their workers
and made arrangements with physicians, who were paid a monthly fee for their services.
These contracts led to the creation of "medical service bureaus" composed of groups of
physicians. The first was organized in Tacoma, Wash., by Pierce County physicians in 1917.
Some bureaus, including
the Pierce County bureau, still operate today as Blue Shield Plans.
- These pioneer programs led to the first Blue Shield Plan, which was founded in California
in 1939.
- The Blue Shield symbol was informally adopted in 1948 by a group of nine Plans known
as the Associated Medical Care Plans and registered at the federal patent and trademark office in 1951. This group eventually became the National
Association of Blue Shield Plans.
- The Blue Cross and Blue Shield Association, created in 1982, is the result of a
merger of the Blue Cross Association and National Association of Blue Shield Plans.
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