Blue Cross and Blue Shield

You probably won't be surprised to hear that the president of Blue Cross and Blue Shield Association is hoping to foster cost-effective medical practices. What's a bit more unusual, however, is his proposal for making that happen. BCBSA head Scott Serota--and others--would like to see the federal government, rather than commercial health plans, play the central role. Article

Physicians have always battled health plans over reimbursement rates. Often, they feel outgunned by health plans which, despite needing doctors, are the ones who ultimately cut the checks. But of late, the tide may …

Blue Cross and Blue Shield of Florida has been ordered to pay $1.5 million to two hospitals as compensation for hospital bills it refused to pay. A jury found that the plan's HMO inappropriately refused to reimburse the two hospitals, Miami's Palmetto General Hospital and Coral Gables Hospital, for certain hospital pathologist services. Eight years ago, the health plan's Health Options HMO stopped paying hospital pathologists for supervising and interpreting tests. In the suit, the …

It's never good for business when you've angered 900,000 doctors. But with any luck, that chapter is over for 23 Blue Cross and Blue Shield plans, which were targeted by a class-action lawsuit alleging unfair payment practices. The suit, which was filed in 2003, asserted that 23 BCBS plans were habitually cheating doctors by deliberately paying for less-intensive services than they had in fact provided. The BCBS plans have agreed to pay $128 million to settle the suit, and pay as much as …

Hoping to make CDHPs more palatable--and to profit on deposits, of course--the Blue Cross and Blue Shield Association is moving to expand the reach of its Blue Healthcare Bank. The bank allows BCBS members to establish health savings accounts, then use debit cards or checks to access HSA dollars. The idea is to make it simpler for consumers to use and track their HSA funds, while saving them the trouble of waiting for reimbursement checks. This, in turn, makes CDHPs more acceptable to …

> With claims falling, medical malpractice insurer The Doctors Co. is paying out more than $100 million in dividends to doctors in several states. Article

> It's just another step in the unholy dance that is trauma coverage in the U.S. This time, two of Georgia's trauma hospitals are considering either cutting back spending or dropping their Level I trauma centers entirely. …

> Despite mounting investments in in-home care, Ohio spends more on nursing home care than 41 other states. Article

> Doctors are taking FDA warnings on child use of antidepressants to heart. Prescriptions of these drugs have dropped dramatically during the past couple of years, according to a new study. …

Blue Cross and Blue Shield of Massachusetts has awarded Boston's Beth Israel Deaconess Medical Center (BIDMC) $100,000 for its work in reducing errors on its obstetrics unit. Thanks to process and administrative changes, the department saw a substantial 35 percent drop in adverse events among patients between 1999 and 2005, and even more notably, a 50 percent decline among high-risk patients during the same period. BIDMC began changing the department's process of care after a newborn …

> Blue Cross and Blue Shield of Minnesota has announced that it will begun funding employee wellness programs for 20 of the state's mid-sized employers. Article

> DC-area blood donations have fallen to a "crisis" level, experts say. Article

> A new study suggests CDHPs that couple the new structure …

> Florida's hospitals are fighting to keep the no-fault personal injury protection provisions of the state's auto insurance law alive. If the provisions die, they could lose $350 million. Article

> Pittsburgh-area businesses, insurers and agencies have come together to support the Bush administration's price and quality transparency proposals for healthcare. …