BC/BS Unveils Five-Point Plan

Stating that "a system that is unaffordable for many today won't work for even more people tomorrow," Blue Cross and Blue Shield Association (BCBSA) President and CEO Scott P. Serota today unveiled a comprehensive five-point plan - "The Pathway to Covering America" - for building on the employer-based system to improve quality, rein in costs and expand coverage to all Americans.

The "Pathway" plan lays out detailed recommendations to change the incentives in today's delivery system to help assure high-quality, affordable care and offers solutions to expand access to coverage. For each of the five action steps, the proposal outlines what Blue Cross and Blue Shield Plans are doing in their local communities and the necessary actions to be undertaken by the government.

In announcing the new initiative at a Washington briefing this morning, Serota was joined by CEOs from two Blue Cross and Blue Shield Plans: Michael Unhjem, president and CEO, Blue Cross Blue Shield of North Dakota; and Daniel Loepp, president and CEO, (more Blue Cross Blue Shield of Michigan. Unhjem and Loepp serve as chairman and vice-chairman, respectively, of BCBSA's Board Committee charged with developing BCBSA's position on key public policy and legislative issues.

Specifically, BCBSA's five-point plan for comprehensive reform includes the following:

1. Encourage Research on What Works. Today, an estimated 30 percent of healthcare spending goes toward care that is ineffective, redundant or inappropriate. America needs an independent institute to support research comparing the relative effectiveness of new and existing medical procedures, drugs, devices, and biologics.

2. Change Incentives to Promote Better Care. The incentives in our system must be changed to advance the best possible care instead of encouraging more services. Providers should be rewarded for delivering high-quality, coordinated care, especially for the increasing number of Americans with chronic illnesses.

3. Empower Consumers and Providers. Consumers and providers must have access to the information and tools they need to make informed decisions. This starts with information systems to manage personal health records. In addition, consumers need to know how much they are paying for their healthcare and what they are getting in return.

4. Promote Health & Wellness. The costs of treating chronic conditions are estimated to account for 75 percent of healthcare spending. As a nation, we must promote healthy lifestyles to help prevent chronic illness and work aggressively to help patients with chronic illnesses manage their own health.

5. Foster Public-Private Coverage Solutions. Coverage plans need to be tailored to capture the diversity of the uninsured population so that no one gets "squeezed out" by cost, "misses out" on available government assistance or "opts out" because they do not think they need health coverage.

"The Blue Cross and Blue Shield System strongly believes that everyone in America should have health insurance," said Serota. "After deliberative and thoughtful discussions, the nation's 39 Blue Cross and Blue Shield Plans have crafted a comprehensive proposal based on our 75 years of experience as leaders in the health community. We look forward to working with other stakeholders to enact comprehensive healthcare reform."

Unhjem added, "To help advance this proposal, in 2008 BCBSA and its Member Plans will engage in a multi-pronged campaign - both nationally and in all 50 states - to inform consumers, small businesses, large employers, policymakers, presidential campaigns, and others about the value of the employer-based system and our vision for improving healthcare."

"Blue Cross Blue Shield of North Dakota is passionate about ensuring value for our subscribers. We are working to provide the right incentives for the delivery of high-quality, coordinated care, helping members make well-informed, value-based decisions about their health and pioneering more effective ways to coordinate care for those with complex needs," Unhjem said.

Loepp said, "A totally integrated healthcare system - one that is based on proven clinical evidence to improve health outcomes and better serve the needs of patients - is the foundation needed to build a delivery system that works. The Blues have taken positive steps in this direction and intend to do even more. The government also must take action if we are to realize this goal. We look forward to working with other stakeholders and policymakers to reform our system and cover all Americans."

The path for achieving this vision is laid out in our comprehensive 5-point reform plan - "The Pathway to Covering America" - that we are releasing today. For more information, visit http://www.bcbs.com/pathwayreport.

The Blue Cross and Blue Shield Association is a national federation of 39 independent, community-based and locally operated Blue Cross and Blue Shield companies that collectively provide healthcare coverage for more than 100 million individuals - nearly one-in-three of all Americans.

Source: Blue Cross and Blue Shield Association

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