Last Updated 27 Jan 2021

Blue Cross Blue Shield

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The Changing Face of Blue Cross Blue Shield Betty Bogart Kaplan University Author Note Correspondence concerning this article should be addressed to Betty Bogart, Student, Kaplan University, 1801 East Kimberly Road, Davenport IA 52807. The Changing Face of Blue Cross Blue Shield Since their founding as individual companies in the early 20th century, Blue Cross Blue Shield has grown to become one of the largest insurance companies in the United States. Blue Cross coverage for hospital care and Blue Shield coverage for physician visits grew to national coverage separately before merging to form the Association we know today.

In 1929 Justin Ford Kimball developed a program to cover teachers for hospital treatment. It guaranteed them 21 days of hospital care for $6 dollars per year. This program was later extended to encompass other employee groups first in Dallas then nationally. The program became Blue Cross. The first Blue Cross Baby was born in a hospital in Dunham, North Carolina. This was the first birth in America to be covered by a health insurance certificate that included maternity benefits. In 1939 the American Hospital Association adopted the Blue Cross symbol for plans meeting certain requirements.

The ties with the AHA were severed in 1970. In the early 20th century employers in mining and lumber camps of the Pacific Northwest developed a plan to cover employees by paying monthly fees to bureaus composed of groups of physicians. Officially the first Blue Shield Plan was implemented in California in 1939. The plan grew and was adopted by the Associated Medical Care Plan, a group of nine separate plans. Later the plan was renamed the National Association of Blue Shield Plans.

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Both programs grew to national coverage as the need for medical insurance continued to grow with industry. The two companies merged to form Blue Cross and Blue Shield Association in 1982. At the time the company was defined as coverage under social welfare plans and was thus tax exempt. In 1986 the tax reform act labeled the company a 501(m) organization which would be subject to federal taxation with special tax benefits under IRC 833. Following this change, BCBSA changed its policies to allow its licensees to be for-profit corporations.

In 1984 the nation’s first heart transplant covered by Blue Shield Association was performed in Stanford University Hospital. This would pave the way for BCBSA to create the Blue Cross and Blue Shield National Transplant Network which would become the Blue Quality Centers for Transplant. Today it includes 60 transplant centers nationwide and covers transplants for heart, lung, kidney, pancreas, bone marrow, and stem cell. In the mid 1990’s the Balanced Budget Act added the Medicare+Choice program. This allowed beneficiaries multiple health plans to choose from.

By 2000, BCBSA processed the majority of Medicare claims. These claims alone totaled over 163 billion. In 2003 over 88 million Americans were covered by BCBSA liscensees. Today 38 companies comprise the BCBSA system which provides coverage for nearly 100 million people including all 50 states, the District of Columbia and Puerto Rico. Nationwide over 95% of hospitals and over 90% of professional providers contract directly with BCBSA companies. Coverage through BCBSA now includes the largest privately underwritten health insurance contract in the world.

The FEP (Federal Employment Program) covers more than 5 million federal government employees, dependants, and retirees. The world of health care is an always changing one and BCBSA is no different. From starting as two separate small programs to growing into a leader in health care and technology, this association is an excellent example of how far the industry has grown and how far we’ve advanced in this country and as humans in general. From transplant research and technology to Medicare, BCBSA continues to stay at the head of the field in all aspects.

From their humble origins of trial programs, Blue Cross and Blue Shield have always been on the cutting edge of new health care and technology. As one of the largest insurance Associations in the United states, BCBSA has continued to improve the quality of health care in the United States. Advancements such as Blue Cross & Blue Shield National Transplant Network and Technologies Evaluation Center have proven the companies’ drive to continually improve health care in the United States.

The biggest concern I have for the future of health care would be affordability. Some families still live paycheck to paycheck barely scraping by and the spiraling cost of health care and health insurance remains out of reach for them. Veterans and elderly benefits are cut to maintain cost while leaving some unfortunates behind. Un-insured people in America was a staggering 50 million in 2010 leading most to believe that something must be done to keep health insurance and health care affordable to everyone.

No one should have to suffer without a physician’s care simply due to lack of insurance. References Blue Cross and Blue Shield Association (http://www. bcbs. com/about-the-association) Blue Cross and Blue Shield of Illinois (http://bcbsil. com/) Blue Cross and Blue Shield Federal Employee Program (http://fepblue. org/) CNN Money (http://money. cnn. com/) Scott P. Serota, CEO Blue Cross and Blue Shield (http://www. bcbs. com/about-the-association/officers/scott-serota. html)

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