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.
BCBST has representative offices in Jackson, Johnson City, Knoxville, Memphis, and Nashville, Tennessee.
The company's statewide provider network includes some 22,000 physician practices, almost 190 hospitals, and 2,300 pharmacy locations.
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 70 million claims and more $10 billion in benefits annually. It pays more than $8 billion in medical claims each year.
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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 2012, the company expanded its capabilities in medical informatics, and partnered with key provider organizations to decrease medical costs. It also cut administrative costs while increasing operating efficiencies. Externally, it expanded the Patient-Centered Medical Home program to 29 practices in more than 85 sites across Tennessee, and began work toward a new bundled payment system focused on improving patient care, quality, and outcomes. Improved pricing and expanded technology are expected to result in $280 million in savings for its customers over the next three years.
In 2012 the company signed a deal with Medco Health Solutions to provide pharmacy benefits to the insurer’s health plan members.
In 2012 Memorial Health Care System and BCBST reached a new five-year agreement. The new contract 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.
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.
To cut costs, in 2012 BCBST announced that it planned to cut 100 positions, or 2% of its workforce across Tennessee.
In 2011 BCBST expanded its technology services by launching a mobile application for members to access plan information. In addition, in 2010 the company redesigned its consumer website to integrate plan management, health monitoring, and wellness tools. It has also established patient-centered medical homes to better monitor a patient's care by connecting him electronically with a coordinating physician.
It has launched a personal health advocacy and information program dubbed Well+Wise, and in 2011 the company extended the program to include a corporate-focused version dubbed Well+Wise at Work.
The company was founded in 1945 when Roy McDonald created the Tennessee Hospital Service Association.