The Blue Cross and Blue Shield Association has repealed a 35-member revenue limit for non-blue businesses, although it has been questioned whether the change will affect competition for its brand.
The rule was that two-thirds of the blue business licensing would come from the Blue Plan Licensor’s national net income from health plans and related services.
BBS A spokesman said the change was “in line with the registrant’s agreement.” $ 2.7 billion initial agreement In October, US District Judge David Proctor was approved in Alabama. The deal seeks to resolve a major lawsuit filed by customers in 2012 alleging that the blue companies were adjusting prices and raising premiums. Blues companies provide health insurance to more than 100 million people, or one in three Americans.
Anteme, who manages Blues plans in 14 states, said he would pay $ 594 million From the role of anti-religious establishment. The There is the Michigan Blues They contribute $ 125 million. A second lawsuit filed by suppliers is still pending in the Alabama Federal Court, where doctors say the anti-competition practice has reduced the amount paid to doctors and other health care providers. Proctor is expected to make a final decision this fall.
The Blue Cross and Blue Shield companies are focused on the goal we have achieved over the past 90 years – improving access to quality health care for all Americans, as the solution continues to be approved by the court and implemented in accordance with the agreement, a BBC spokesperson said in an email.
The end of the revenue regulation will boost big Blues plans and force small licenses to quickly integrate with big companies such as the Blue Cross and Blue Shield plans in five states, health care analyst Paul Kekley said.
“You’ll see some reinforcement in the blues,” says Keckley. I think you will see the big plans start creating exciting collaborations, instead of competing with each other, let’s create something that competes with United.
He said long-term consolidation is possible in states such as Pennsylvania, where many blues plans are in place. Keckley also said that like Michigan, which controls more than 70% of the state’s health insurance market, it could see mergers between state, non-profit plans and major blues. However, he pointed out that it would be an obstacle to ask these free trademarks to relinquish their unique license to be blue.
“I’ve been able to see some of the nonprofit community health plans that are willing to have those discussions,” Keckley said. Where the world has a history of being a blues supplier in one of these worlds, as a priority, or a spectrum, the provider has sponsored its own health plan to bring blues. Practical skills and further steps, I see that is happening.
The lawsuit alleges that competing blues plans allow companies with 5,000 or more employees to run self-funded businesses in non-commercial states. This can create more options for employer clients.
As the Blues become more competitive, Keckley said it expects its insurers to create new products with narrower networks and lower premiums, according to a company known for its extensive network of hospitals in the city. The move will strengthen discussions between some blues to create data warehouses, where they will share their data and fund analytics to set up a new company.
“Like the United States, Humana, Signa, Senten, they are starting to look like multiple lines in many markets and in many areas of business,” Keckley said.
Glenn Melnik, a professor of health care at the University of Southern California, said the change would open up potential investment in non-bluetooth products and encourage innovation. Finally, he says, this is good for the consumer.
If they stick to their own little geography, why waste their time creating something new, says Melnick. Now, if it happens suddenly and the whole country becomes a potential market, this investment will increase the chances of a return.
But in the past, the success of non-bluetooth brands has been limited by the changes in the market, said Brad Ellis, senior insurance analyst at Fitch Ratings. Because blues production is so strong, there may be little incentive to invest in other products. Anthem, for example, completed his Unicar health plans after struggling to “make that non-bluetooth brand profitable”.
While the change may lead some to join their blues business with companies in other states, Ellis said she does not believe it will affect many blues, let alone other insurers. He declined to mention the companies that own the Blues. A more tangible change was that the Blues should have been asked to compete with each other in the same geography, and I believe that Ellis would face a mountain legal battle, even though this requirement would limit their ability to divide their territory.
Ellis said: “I’m not sure that lifting this rule and saying that a blues company can have half of its work instead of being one-third now will affect the competitive edge.”