Blue Cross and Blue Shield Plans Developing Innovative Programs to Provide Affordable Healthcare for Uninsured Americans

7/8/2003

From: Brian Crawford of Blue Cross and Blue Shield, 312-297-6161; e-mail: brian.crawford@bcbsa.com; web: http://www.bcbs.com

CHICAGO, July 8 -- The rising number of Americans without healthcare coverage creates serious health and financial risks for millions and further compounds the challenge of keeping healthcare affordable. Blue Cross and Blue Shield Plans are tackling the problem by developing innovative programs to reduce the number of uninsured.

A new study released today by the Blue Cross and Blue Shield Association (BCBSA) looks at how the lack of preventive healthcare services for the uninsured contributes significantly to hospital inpatient costs.

The study, conducted by Richard Siegrist, Jr., Adjunct Professor of Management at the Harvard School of Public Health, found that inpatient costs for the uninsured are 12.3 percent higher than costs for patients with private insurance. Uninsured patients with manageable health conditions or chronic illnesses like diabetes or asthma impacted these costs significantly.

The research underscores the need for targeted programs to reach the uninsured. For example, Blue Cross and Blue Shield Plans have developed innovative programs to get uninsured individuals who qualify enrolled in existing government programs and to create affordable new products for middle-income individuals, families and small businesses.

Increasing participation in government-sponsored programs

-- Blue Cross and Blue Shield of Alabama's Child Caring Program helps uninsured children, 18 and under, that are not eligible for governmental coverage. The plan is offered free for enrolled children with no premium contribution, deductibles or co-insurance. Services covered under the program include all outpatient visits and procedures, immunizations, emergency medical care, vision care, and drugs administered in the outpatient setting. The Plan matches donations from public and private organizations dollar-for-dollar and also covers all administrative expenses so that 100 percent of the funds go to provide health care. The program has enrolled more than 43,000 children since its inception, with more than 7,000 currently enrolled.

Programs for middle class individuals and families:

-- Anthem Blue Cross and Blue Shield's individual products are popular with students no longer eligible for their parents' health plan, entrepreneurs wanting single coverage, people between jobs and workers who take early retirement but aren't eligible for Medicare. Competitively priced and affordable, with plans available for less than $100 a month, the PPO is most popular, offering what consumers have said they want to feel secure: predictable flat-dollar copays for coverage for doctor's office visits; prescription drug coverage; coverage of preventive care and urgent care; and the BlueCard benefit, which provides in-network benefits when traveling outside the home network area. Deductibles range from $250 to $5,000. Online quotes are available, and there are significant discounts on health-related items such as eyeglasses, fitness memberships and massage therapy -- with customized health information available through http://www.anthem.com.

Programs for small businesses

-- Blue Cross and Blue Shield of Louisiana (BCBSLA) launched trueBLUE in 2001 specifically for the nearly one-fourth of Louisiana's small businesses that do not offer health insurance benefits to their employees. With trueBLUE, business owners can realize premium savings of up to 28 percent over other BCBSLA PPO plans. The trueBLUE plan features a unique benefit design that makes premiums less expensive for employers by allowing members to share more of their first-dollar healthcare coverage. It covers a full array of wellness services and is available in both Preferred Provider Organization (PPO) and traditional indemnity plans offering a variety of deductibles and out-of-pocket maximums.

"Understanding who the uninsured are and how healthcare costs affect them is the first step in the solution process," said BCBSA President and CEO Scott P. Serota. "For example, there are more than 14 million children and adults who are eligible for, but not enrolled in, existing public programs such as Medicaid and SCHIP. Blue Cross and Blue Shield companies across the country are working with local leaders to help reach these people who could have coverage and don't even know it.

"More than 13 million uninsured Americans have incomes of $50,000 or more. In fact, the fastest growing segment of the uninsured has incomes of $75,000 and above. The challenge immediately before us is to design affordable health insurance plans that address the most pressing cost needs within this portion of the uninsured population," he said.

"Covering the uninsured in America must be done in a way that promotes better health and affordability for consumers," Serota continued. "This research shows it is vital that we encourage people to take better care of themselves, promote quality relationships with their physicians and help them understand the importance of prevention and care management."

According to the Siegrist research, a lack of participation in appropriate preventive and health management programs causes inpatient admissions for uninsured patients with diabetes or asthma to be up to twice as high as those with private insurance. Patients with chronic illnesses had longer lengths of stay and typically required more intensive treatments compared to patients with private coverage, according to the study.

For more information about products offered for the uninsured through your local Blue Cross and Blue Shield company, go to BCBS.com and select the "Get Insurance Purchase Information" option in the main page.

The Blue Cross and Blue Shield Association is comprised of 42 independent, locally operated Blue Cross and Blue Shield plans that collectively provide healthcare coverage for more than 88.7 million -- nearly one-in-three -- Americans. For more information on the Blue Cross and Blue Shield Association and its Plans, visit http://www.bcbs.com.