The Tennessean ran a great story written by Sherri Zink the Chief Data Officer for BCBST this weekend. A few takeaways I think you will be interested in are"
- In 2016 BCBST paid out $13.9 Billion for health care services
- This covered care for 3,4 million members for an average cost of $4,088 each
- Costs were 8.4% higher in 2016 than they were in 2015
- Pharmacy costs have increased by 81% from 2013 to 2016
- In 2016, half of all medical costs were attributed to 25% of the members who were treated for cancer or one of five chronic conditions (diabetes, cardiovascular disease, asthma, COPD or congestive heart failure
What is BlueCross BlueShield of TN doing to combat this trend and try to control costs? First is the direct negotiation with providers and working to shift payment methods to reward better health outcomes. Many complain when the "newest" prescription they ask for is denied but this is an out of control cost and in many cases this "new medicine is no better than the old one for a patient, it only costs 10x more. BCBST is working harder to to stay in touch with those who have chronic conditions to ensure they are getting the care they need and are compliant on medications.
To read the entire story click here