Blue Cross and Blue Shield were created separately; Blue Cross provided coverage for hospital services, unlike Blue Shield that covered physician services. Blue cross was formed by Justin Ford Kimball in 1929; Justin Ford Kimball was also Vice President of Baylor University’s health care facilities. The first plan started in Dallas, Texas and guaranteed teachers hospital care for 21 days at the rate of $6 a year, Then later on the plan was extended to other employee groups in Dallas, and then nationally. Furthermore, Blue Shield was developed in the beginning of the 20th century. The first official Blue Shield plan was founded in California in 1939. Then around 1948, their symbol was adopted by the nine plans called the Associated Medical …show more content…
In 1982, Blue Shield merged to the Blue Cross Association and formed the Blue Cross and Blue Shield Association. “The Blue Cross Blue Shield Association (BCBSA) is a federation of 37 separate health insurance organizations and companies in the United States. Combined, they directly or indirectly provide health insurance to over 100 million Americans” Also, in 1933, Minnesota was the first “blue” health plan in the nation. When seven St. Paul hospitals got together and formed the “Minnesota Hospital Association” Therefor, it became the country’s first pre-paid health care network. The Blue’s earliest ad was a nurse with a blue cross armband on her uniform sleeve. This was the beginning of their iconic logo. Minnesota’s branch became the first health plan to be known as “blue cross.” Less than 10 years later, the name and symbol was adopted by the national Blue Cross Association. Blue Cross became one of the most recognized and trusted health care brands in the world. Blue Cross is considered a Private/ Commercial; this means that this type of insurance is not paid by the …show more content…
In most cases, the Platinum Plan will cover 90% of the cost, so you would only be left with paying 10%. This is a clear example of the more you pay for your premium the less the deductible would be. If this kind of plan is not in your price range, Blur Cross also provides the Bronze Plan. This Plan has the lowest monthly premium and often low-out-of –pocket cost. The plan would cover 60% of the cost while you pay the 40%. Also, if you feel you don’t want to commit yourself to health plan, just yet, Blue Shield provides the option of the Short-Term Plan. The Short-Term health insurance provides temporary coverage for as far as 11 months. This plan covers most of the many costly health care services to insure you and your family protected. In addition, Blue Cross also offers HMO and PPO Plans. These two plans have some similar aspects, in both plans they guarantee these types of coverage’s. For Instance, primary care provider (PCP) from your plan network, your PCP oversees your care and refers you to a specialist, and your care is covered when your doctors and hospitals are members of your plan
Corresponding to the losses for 2013, the organization introduced a health plan, Sutter Health Plus, in 2013. In addition, Anthem Blue Cross and Sutter Health signed an agreement to continue as part of the Anthem network (Sutter Health, 2015).
Blue Cross Blue Shield of Florida (BCBSFL) Operating Services is Florida’s largest insurer, serving more than 6 million residents in total. Three trends that redefine how Blue Cross Blue Shield of Florida brings value to its members are through consumer empowerment, E-business, and financial services modernization. BCBSFL holds approximately 30% of the HMO market share in Florida, which is twice the share of its nearest competitor. BCBSFL offers a BlueComplements program filled with discounts and services that allow members to stay healthy. Theses advantages include Healthy Alternatives, Vision One, TruVision, Hearx, GlobalFit, SafeTech, and Walgreens Mail Order Pharmacy.
An HMO is a integrated delivery system that combines both the delivery and financial aspects of health care for consumers. Under the HMO, each patient is appointed to a primary care physician (PCP), who is essentially accountable for the long-term care of the members that she/he has been assigned and any specialists that a patient needs to see should be referred by their PCP. Some examples of HMOs are Kaiser Permanente and Humana. HMOs are licensed at the state level, under a license that is known as a certificate of authority. A pro of an HMO is that treatment for a patient can begin prior to their insurance being authorized; A member may benefit from this because there would be little to no treatment delays.
According Banner Healthcare (2016), “BHN collaborates with many commercial and government payers, plus large employer groups, to deliver on the triple aim of lower costs, high quality care and an excellent patient experience. Healthcare can be affordable with a design that engages the physician, patient and payer in seeking the best care and health outcomes” (p.2).
Instead, a part of the internal return is used to pay for the health coverage. Insurance companies typically provide a payout of up to 300% of the aggregate value of a policy for up to three years after the value of the account is depleted. For example, a policy owner, who has a $100,000 annuity and has chosen a two-year benefit factor and aggregate coverage limit of 300%, would immediately create a pool of money worth $200,000 to cover long-term care expenses and another $200,000 of life insurance benefits (Health Insurance, 2016). This only takes effect after the initial policy value, which is $100,000, is depleted. But, if the policy holder is healthy and does not need health care, the unused benefits will be paid out as a lump sum to the policy holder or to any named beneficiary (Health Insurance,
The second option is Medicare Advantage Prescription Drug Plans (MA-PDs). MA-PDs offer hospital, medical and prescription drug coverage under one policy, perhaps an HMO or PPO. “To join a Medicare Advantage plan, you must have Part A and Part B” (Medicare & You 2014).
Managed care dominates health care in the United States. It is any health care delivery system that combines the functions of health insurance and the actual delivery of care, where costs and utilization of services are controlled by methods such as gatekeeping, case management, and utilization review. Different types of managed care plans came into development by three major factors. These factors include choice of providers, different ways of arranging the delivery of services, and payment and risk sharing. Types of managed care organizations include Health Maintenance Organizations (HMOs) which consist of five common models that differ according to how the HMO is related to the participating physicians, Preferred Provider Organizations (PPOs), Exclusive Provider Organizations (EPO), and Point of Service Plans (POS). `The information management system in a managed care organization is determined by the structure of the organization' (Peden,1998, p.90). The goal of a managed care system is to provide subscribers and dependants with needed health care services at the lowest possible cost. Certain managed care plans also focus on prevention by trying to keep members healthy.
Health insurance is currently an important issue in the United States. Everyday more and more Americans become uninsured due to job loss and an increase in premiums. These Americans add to the ever growing population of 45.7 million people who are currently uninsured (Bialik). Moreover only 27% of those uninsured are under the age of 65 (NCHC). This is staggering considering most of those who are uninsured have, or soon will, suffer from some sort of illness or injury. As a result they will not be able to afford proper treatment. Insurance premiums can range in cost from fifty dollars per month, to fifteen hundred dollars per month (Kreidler). An individual’s premium is determined by factors they choose as well as other factors looked at by their provider. The cost of health insurance in America varies depending on the controllable factors, like particular insurance policies, and uncontrollable factors, like age.
2. Blue Cross/Blue Shield of Kansas, (2004), The rising cost of health care, the reasons.
The first health insurance plans began during the Civil War in the mid 1800’s, with the earliest plans only covering against accidents related to travel via rail or steamboat. Eventually, plans became more elaborate, covering all illnesses and injuries. In 1929, the first modern group health insurance plan was formed. In Dallas, Texas a group of teachers contracted with Baylor Hospital for room, board, and medical services in exchange for a monthly fee. And in 1932, Blue Cross and Blue Shield offered group health insurance plans for the first time (Neurosurgical Medical Group, 2007).
How has the healthcare industry changed (pre-1983 to post 1983)? What are the implications for BD? How has BD managed to build up an 80% market share in this market? Which many competitors bigger than BD have tried to enter without success?
The three main types of health insurance in the United States are voluntary, social and welfare. These types on insurance a person possess sometimes determine the ability to seek care and how that care is given. Insurance types such as voluntary and social insurance can be very expensive and will make participants consider how important it is for them to see the doctor, while welfare medicine participants have trouble finding a doctor due to the limit number of physicians who are provider or are refusing to take on new patients. Some of the types of voluntary insurance are Blue Cross and Blue Shield (BCBS), private and commercial insurance, and health maintenance organizations. Voluntary insurance is not only limited to health care from physicians, but can also include dental, long-term, and life insurance. One of the most popular voluntary insurance companies is BCBS. Sometime people have trouble paying for insurance especially if is as it related to an on the job injury or because they have reached retirement age and can no longer work.
Medicaid dates back from July 30th, 1965 when Lyndon B. Johnson was in office. ...
Before “Patient Protection and Affordable Health Care act.” Americans were not required to purchase and the cost of insurance went up to cover the uninsured. The closest America has come to a single payer system ie, “Universal Healthcare” is the “Patient Protection
Health insurance provides benefits for sickness, injury, surgery, and prescription medication. There are a variety of plans with different