Bluecross Blueshild Case Study Summary

This week I began my 6-week internship at Blue Cross Blue Shield of Nebraska (BCBSNE). The first day was a common orientation for all new employees, internally denoted to as the “onboarding process” where all employees are told they matter. This full-day session communicates the core mission, vision and goals of BCBSNE, organizational structure, operating objectives, and workplace culture. BCBSNE is a not-for-profit health insurance company that is focused on collaboration to find the best solution for their customers; in other words, they are customer-focused. Since the implementation of the Affordable Care Act (ACA), many changes to the health insurance market required a change in the organizational structure and culture of BCBSNE. Through partnerships with providers, the goals of BCBSNE are to be responsive, accountable, minimize errors, and decrease costs – all components of the ACA. BCBSNE has strategically aligned their goals to those of the government-mandated goals, and implemented them at all levels of the organization, making them competitive in the health insurance market. I found this very fascinating: I was very excited after day one!

While our understanding has evolved with respect to certain advantages of MCO’s, our understanding of the disadvantages has also grown. This analysis will evaluate the use of MCO’s as a gatekeeper to controlling health care cost and offerings. It will evaluate the advantage MCO’s provide in a rapidly growing market due to the aging of baby boomers. The analysis will evaluate disadvantages that can arise with relying on MCO’s. These disadvantages work against the insurance company forcing a polarizing balance between how much control the MCO should retain over recommendation and provision of services.

Compare the advantages and disadvantages of your choice to another of the other managed care organizations not yet

Because each type of managed care organization has certain unique characteristics, network strategies must be chosen to fit these characteristics. An organization that offers more than one type of health plan may choose to coordinate provider networks through a network-within-a-network approach. This is done by including the providers from one product's panel in the network of another panel. Provider network strategies are also found to vary with the geographic scope and market focus of the plan. A growing number of managed care organizations are attempting to build national provider

Established in the 1930s by Henry J. Kaiser and Dr. Sidney as a health care program for construction, shipyard, and steel mill employees, in 1945 Kaiser Permanente (KP) opened enrollment to the public (Our History, 2016). Despite many challenges and setbacks, KP has grown to become one of the largest leading healthcare providers (SPEC Associates, 2011; "Labor Management," n.d.). However, is KP ready to meet the health care needs of citizens in the next decade? This paper will delve into KP to assess their readiness as well as their strategic plans regarding network growth, adequately staffing nurses, managing resources, and maintaining patient satisfaction.

Blue Cross and Blue Shield of Illinois (BCBS) is considered the largest and most experienced insurance company in Illinois. BCBS was founded in order to provide healthcare to teachers at a reasonable cost. It services over 7 million people. Its mission is “To promote the health and wellness of members and communities through accessible, cost-effective, quality health care” (Blue Cross Blue Shield, 2012). Blue Cross Blue Shield provides its customers with affordable health care. The parent company is Blue Cross Blue Shield Association its signature tag is “Creating Healthier Communities,” BCBS does not have any investors and the customers are considered the investors of the company and essentially who BCBS answers to. This is an important factor because they do not have to keep investors interest in the forefront of decision making, but rather they have the interest of their client in mind. (Blue Cross Blue Shield, 2012) In 2013 the Chicago based company reported profits of 684.3 million dollars. The company employees over 17,000 people. “Blue Shield of Illinois fell well below the $1 billion mark for the first time since 2009, in part because the insurance giant is setting aside money to offset expected losses from the troubled rollout of Obamacare” (Wang, 2014). Despite this setback it continues to expand over various parts of the United States. BCBS

Health Choice Insurance Co. is a managed care organization which provides health plans beneficial for you, your family or your company. Although the company is based out of Arizona, it is affiliated to IASIS which has its presence in Utah, Texas, Nevada, Louisiana, Colorado, Florida, Arkansas and Arizona. Being a subsidiary of IASIS, Health Choice Insurance Co. provides Medicare as well as Medicaid services in Utah and Arizona area. Being relatively new in this industry, from 1998 Health Choice Insurance Co. have been successful in expanding their network to 19 acute care units and one behavioral hospital in 8 different states such as

The purpose of this essay is to discuss and learn the story of Baylor Scott & White Healthcare, which has been known for high quality medical care for its clients. The discussion aims to review the history of Baylor Scott & White Healthcare, its corporate structure and even the business model that it uses.

Blue Cross Blue Shield does have a strong presence in the insurance community, whether that is in the Choices program, Medicare, or private policies. Government restrictions are a significant barrier to entry in multiple venues of healthcare. Brand loyalties and government restrictions are both barriers to entry in this situation.

Blue Cross Blue Shield is one of the largest insurance companies in all of America: over 98 million people in the country are currently insured by this juggernaut. And due to the Mental Health Parity and Addiction Equity Act of 2008, they are potentially one of the largest providers of drug rehabilitation insurance coverage in the world.

It was in 1977 that the United Healthcare United Health group was founded by Richard Burke. The headquarters of the company are in Minnetonka, Minnesota. This organization works towards the betterment of people's health, it help them in living a healthy life by providing them with the kind of health care that would be best for them. The main focus of United Healthcare which is a major division of the United Health group is to provide the people with better health benefits and coverage.

Mutual of Omaha Medicare Supplement is among the top 3 insurance companies that are offering Insurance. They have superior customer service, very economic claims processing, as well as health-care render like working with them. The Medicare Supplement client service section is outstanding, as well as their claims process is flawless. This is really a first-class organization, and the outcomes are the same among all the other companies. They treat the customer very well and always pay their bills without any questions. Once you select the plan, there is rare chance to switch the company. The duty of this is to provide the best service to the customer so they may improve their sense of security and most important their health.

Providing quality delivery care is the cornerstone of Kaiser operation and addressing language needs of the diverse communities it serves is receiving attention from the National Diversity and Inclusion Office. Kaiser’s National Diversity and Inclusion was established with the objective to promote, support, and assist the regions in implementing the Kaiser Permanente Board of Directors agenda in providing culturally competent medical care and culturally appropriate services to improve the health and satisfaction of its members.

The Omega Ultrasound System would be the best choice to green light for the Healthymagination initiative. After assessing all the potential products, we determined that the lack of concrete metrics, difficulty or uncertainty in measuring outcomes, or clinical relevance to the Healthymagination goal rendered the TEEMax, UltraLipo, and HepEcho unfit for launch. We’ve outlined justification for this decision in (Figure 1.), but we believe the Omega system provides the greatest opportunity for meeting Healthymagination standards with the best chance of obtaining definitive evidence to support the certification.

The Fortune 500 company I chose is CVS Health. I chose this for a few different reasons. First, I recently had to visit the Minute Clinic in the CVS store twice within the last month. Secondly, I chose CVS because it is part of the health care initiative and I work for a healthcare company.