36 Blue Cross Blue Shield Health Insurance Companies Explained

Summary

Dr. Eric Bricker's video discusses the complexity of the Blue Cross Blue Shield (BCBS) system in the U.S., highlighting that it is a network of 36 independent companies, each with its own geographic boundaries and unique plans. BCBS Association, based in Chicago, licenses the BCBS name to these entities. Anthem, the largest for-profit BCBS plan, stands out with its significant market presence and public trading. The video also touches on the non-profit nature of many BCBS plans and the unique case of Pennsylvania, which has three competing BCBS plans. The intricacies of the system, including back-office operations handled by subsidiaries like National Alliance, are emphasized.

Takeaways

• 🔍 Blue Cross Blue Shield is a significant entity in American healthcare, affecting about a third of Americans according to their website.
• 🏢 The Blue Cross Blue Shield Association consists of 36 individual companies, each a separate legal entity, with a shared provider network.
• 📍 Geographic boundaries are typically respected among the 36 plans, with each plan serving its specific region without competition from others.
• 🏆 Anthem stands out as the largest and most prominent Blue Cross plan, being a for-profit, publicly traded company with substantial revenue and membership.
• 🌐 HCSC, or Health Care Service Corporation, operates under different names in various states but is a single non-profit entity behind these plans.
• 🏭 Pennsylvania is unique for having three different Blue Cross plans that sometimes compete with each other within the state.
• 🏥 Other notable Blue Cross entities include Highmark, CareFirst Blue Cross, Premera Blue Cross, and Blue Cross of California, each serving specific regions.
• 🔄 Blue Cross and Blue Shield of South Carolina operates a subsidiary, National Alliance, which provides back-office services for 11 smaller Blue Cross plans.
• 📞 When customers call customer service for a Blue Cross plan, they might be speaking with a National Alliance employee even if it's not their local plan.
• 📈 The complexity of the Blue Cross Blue Shield system can be confusing due to the overlapping plans, different names, and shared yet distinct operations.

Q & A

What is the significance of Blue Cross Blue Shield in the American healthcare system?

Blue Cross Blue Shield is significant in the American healthcare system as it touches the lives of approximately one-third of Americans, making it a major player in providing health insurance coverage.

How many individual companies make up the Blue Cross Blue Shield Association?

There are 36 individual companies that are part of the Blue Cross Blue Shield Association.

What is the role of the Blue Cross Blue Shield Association based in Chicago?

The Blue Cross Blue Shield Association, based in Chicago, serves as the licensing body, providing licenses to be a Blue Cross member organization and overseeing the collective operations of the 36 individual companies.

How do the 36 Blue Cross organizations operate in terms of competition and service provision?

Most of the 36 Blue Cross organizations do not compete with each other as they have specific geographic boundaries. Each organization is a separate legal entity but shares a network, forming part of the Blue Cross provider network.

What is unique about Anthem among the Blue Cross plans?

Anthem is unique as it is a for-profit company, publicly traded, and the largest Blue Cross plan with significant revenue and a large number of members. It operates under different names in different states, such as Empire Blue Cross Blue Shield in New York.

What is Healthcare Services Corporation (HCSC) and its relationship with Blue Cross Blue Shield?

Healthcare Services Corporation (HCSC) is the parent organization for several Blue Cross plans, including Blue Cross and Illinois, Texas, Oklahoma, New Mexico, and Montana. It is a non-profit organization and does not have a public stock offering.

Why is Pennsylvania unique in terms of Blue Cross plans?

Pennsylvania is unique because it has three different Blue Cross plans that sometimes compete with each other, which is unusual as most states have only one Blue Cross plan.

What is the role of Blue Cross South Carolina's subsidiary, National Alliance?

National Alliance, a subsidiary of Blue Cross South Carolina, acts as the back office for 11 out of the 36 Blue Cross plans, handling claims processing, customer service, case management, and disease management.

How does the back-office outsourcing to National Alliance affect the smaller Blue Cross plans?

For the smaller Blue Cross plans that outsource their back-office operations to National Alliance, they essentially function as sales, marketing, and client success organizations, as all other operational aspects are managed by National Alliance.

What is the complexity of the Blue Cross Blue Shield system as described in the script?

The Blue Cross Blue Shield system is complex due to the number of individual companies, their geographic boundaries, the mix of for-profit and non-profit entities, and the varying degrees of competition and cooperation among them.

How does the script describe the structure and operation of the Blue Cross Blue Shield system?

The script describes the Blue Cross Blue Shield system as having a central association with 36 individual, legally separate companies that share a network but operate within specific geographic boundaries. It also highlights the unique cases of companies like Anthem and HCSC, and the role of National Alliance in managing back-office functions for smaller plans.