Blue Cross Shield

Earlier this year on January 23, 2008, Blue Cross Shield Association President and CEO Scott P. Serota unveiled Blue Cross Shield’s “The Pathway to Covering America.” This comprehensive five-point plan, developed by Blue Cross Shield, intends to build on the employer-based insurance benefits system to improve quality, rein in costs, and expand coverage to all Americans.

Blue Cross Shield’s “The Pathway” lays out detailed recommendations to change the incentives in today’s delivery system to help assure not only high-quality, affordable health care, but also expand access to coverage. Each of the 5 steps details what Blue Cross Shield plans to do in their local communities and the necessary actions to be undertaken by the government.

This Blue Cross Shield five-point plan for comprehensive reform includes the following:

1. Encouraging research on what works. Nowadays, Blue Cross Shield estimated that 30% of healthcare spending goes toward ineffective, redundant, or inappropriate care. Blue Cross Shield suggests that America requires an independent institute to support research comparing the relative effectiveness of new and existing medical procedures, drugs, devices, and biologics.
2. Changing incentives to promote better care. The incentives in our system need to be changed to advance the best possible care instead of rewarding more services. Blue Cross Shield feels that providers should be rewarded for delivering high-quality, coordinated care, especially for the growing number of chronic illnesses.
3. Empowering consumers and providers. Both consumers and providers need access to the information and tools needed to make informed decisions. It starts with information systems managing personal health records. Also, consumers need to know how much they’re paying for healthcare and what they’re getting in return.
4. Promoting health and wellness. Costs of treating chronic conditions have been estimated by Blue Cross Shield to make up 75% of healthcare spending. As a nation, Blue Cross Shield feels we need to promote healthy lifestyles to help prevent chronic illness and work aggressively to help patients with chronic illnesses manage their own health.
5. Fostering public-private coverage solutions. Coverage plans should be tailored for the diversity of the uninsured population so no one gets squeezed out by cost or misses out on government assistance or opts outs because they don’t think they need health coverage.

Unlike HMO health insurance,“The Pathway” stems from Blue Cross Shield’s belief that all everyone in America should have health insurance. All 39 Blue Cross Shield Plans worked out “The Pathway” based on their 75 years of experience in the healthcare community. A multi-pronged campaign will touch all 50 states, informing consumers, small businesses and large, policymakers, presidential campaigns, and others about Blue Cross Shield’s vision for improving healthcare and the value of the employer-based system.

Blue Cross Shield believes that a totally integrated healthcare system based on proven clinical evidence to improve health outcomes and better serve patients is the proper foundation for a delivery system that works. The government though must also take action along with stakeholders and policymakers to reform the healthcare system and cover all Americans. Only all together can the “The Pathway” be achieved.