Sunday, May 18, 2014

Let's Talk Cost

BlueCross BlueShield of North Carolina (BCBSNC) has the majority of the private insurance market share in the state of North Carolina. BCBSNC lists its membership at 3.7 as of December 2012, which is around 38% of the state's entire population of 9.7m as of December 2012. Bills targeting BCBSNC tactics in the state are covered in the popular press with ranges of BCBSNC share of private insurance in the state listed in the local press as 70% as of May 2013. The insurance exchange marketplace will increase BCBSNC enrollment.

BCBSNC relaunched an educational campaign about health care costs with a well-crafted website called LetsTalkCost and corresponding television ads. The materials are presented in simple language and easily understood. The point appears to be to spread the blame for costs across the entire distribution chain, including blame on patients. Among the 30 costs depicted, 8 describe patient lifestyle choices (like smoking), 7 describe provider wastes (like duplicate medical tests), and hidden costs (like uninsured patients). Only 2 pertain to insurance companies and reimbursements.

The 20 solutions offered reference 17 costs and leave 13 costs highlighted without any solutions. For example, 6 solutions target reducing "Emergency Room Overuse" but there is no solution offered for hospital infections. 15 solutions target patients doing something (like asking doctors additional questions), 8 solutions target providers doing something (like offering free clinics), and only one solution targets the insurance reimbursement structures.

The BCBSNC cost campaign is prone to skepticism and easily perceived as targeting public opinion for political benefit rather than attempting to influence patients or providers. It's a wonder how successful the campaign has been or will be. I'm surprised BCBSNC did not turn to a consortium approach instead of launching their own effort that is very clearly branded as Blue Cross.

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