BlueCross BlueShield of Tennessee (BCBST) is the oldest and largest not-for-profit managed care provider in the state of Tennessee. Serving 3.1 million people through group and individual policies, the company offers HMO, PPO, and high-deductable health plans. BCBST also provides Medicare plans to another 1 million customers, and its Group Insurance Services unit brokers vision, dental, life, accident, and disability plans. Its Volunteer State Health Plan unit provides coverage for low-income members and children through state-sponsored programs. BCBST is a member of the Blue Cross and Blue Shield Association.
The company's statewide provider network includes some 22,000 physician practices, almost 190 hospitals, and 2,300 pharmacy locations. Subsidiary Group Insurance Services provides ancillary services including a complete employee benefit package and long-term care insurance, while Onlife Health is a personal health coaching company operating throughout the country.
For an insurance provider, data is all, and BCBST is working to improve the overall quality of its services through enhanced data management. The company's information services units include Shared Health, a health information exchange, and Gordian Health Solutions, an employee wellness management firm. BCBST also owns a minority stake in the TriZetto Group, which offers enterprise software, outsourcing, and other services for the health care industry. BCBST also offer dental plans.
BCBST pays more than 76 million claims and more than $11 billion in benefits annually. It pays more than $8 billion in medical claims each year.
BCBST has representative offices in Jackson, Johnson City, Knoxville, Memphis, and Nashville, Tennessee.
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BCBST's customer base is made up of some 15,000 group benefit accounts (for corporate businesses) and 3.1 million individual policyholders. The company reports a 94% Group Retention Rate.
In 2013 the company's total gain was $256 million, comprising a $202 million net gain from premiums and fees and a $54 million gain from investments. Federal, state, and local tax expenses fell $14.6 million that year versus 2012 to $270 million.
The company has been working to expand its capabilities in medical informatics, and partnering with key provider organizations to decrease medical costs. It has also cut administrative costs while increasing operating efficiencies. Improved pricing and expanded technology are expected to result in $280 million in savings for its customers by 2016.
As an example of its partnerships with care providers, BCBST has a contract with Memorial Health Care System that allows BlueCross members to use services at Memorial Hospital, Memorial Hospital Hixson, and the Mary Ellen Locher Breast Center on an in-network basis in the health plan’s Network P and Medicare Advantage products. In 2014 BCBST partnered with MissionPoint Health Partners to offer a dual-network insurance plan helping employers in Middle Tennessee manage their health care spending.
To attract new health members, BCBST has expanded its offering of high-deductable plans, which allow customers to use pre-tax health savings accounts to provide a low-premium offering. To cut health care costs and improve members' health, the company is also expanding its wellness and disease management programs.
In late 2014 the company opened a new service center in Nashville.
The company was founded in 1945 when Roy McDonald created the Tennessee Hospital Service Association.