More than 85 years ago, Blue Cross and Blue Shield companiespioneered the idea of health insurance, and they've been at the heart of healthcare ever since.
Part of this proud history is the unique role that the Blue Cross and Blue Shield System played when President Lyndon B. Johnson signed Medicare into law 50 years ago, on July 30, 1965.
At the time, no other entity in the country was equipped with the infrastructure or computing power to process the amount of data needed to turn the vision and hope of Medicare into a reality for the nation's elderly. So the government turned to the Blues, and we were there.
More than 19 million Americans enrolled in Medicare in its first year. Nearly 5 million were admitted to hospitals as Medicare patients, with each hospital admission and visit requiring claims to be seamlessly handled for the patient, medical provider and federal government.
Community by community, the Blues were there to help give birth to this innovation, and Blue Cross and Blue Shield companies have brought security and stability to millions of Medicare patients since.
Five decades later, the independent Blue Cross and Blue Shield companies are still partnering with government and the medical community to ensure that Medicare continues to innovate, so it can remain successful for the next 50 years.
Each day, 10,000 baby boomers turn 65. It's a generation that is known for changing America—and Medicare must change with it.
Medicare still is largely based on a payment system that rewards doctors, hospitals and other medical professionals for the volume of services they provide. It must transition to one that pays doctors for quality and coordinated care that helps people get healthy faster and stay healthy longer.
Recently, the Obama administration announced a goal of transitioning Medicare to just this type of patient-centered care. And Blue Cross and Blue Shield companies are collaborating again to bring private-sector know-how to help this critical public program thrive.
Blue Cross and Blue Shield companies were the only insurers selected by Medicare to partner in all seven regions that are the testing grounds for a four-year initiative to strengthen primary care. And Medicare turned specifically to Blue Cross and Blue Shield of Massachusetts as a model on which to pattern its own accountable care programs. It did so for good reason: The New England Journal of Medicine found that after four years, the Massachusetts program has resulted in increased quality of care and significant cost savings, ranging from approximately 6% to 9% annually over the four years studied.
Indeed, Blue Cross and Blue Shield companies around the country are at the forefront of healthcare delivery and payment reforms. Across the Blues system, more than 25 million members are benefiting from patient-centered care programs that are showing results: fewer unnecessary emergency room visits; fewer hospital admissions and readmissions; reduced hospital infection rates; and better outcomes in key quality measures including breast cancer screening, improved cholesterol control and better adherence to the best practices for treating diabetes.
More than two-thirds of Medicare patients have two or more chronic conditions. They can benefit greatly from care that focuses on prevention and the effective management of their conditions, rather than the treatment of their worst symptoms. With 86 cents of every healthcare dollar spent treating chronic disease, it's obvious that the traditional “one size fits all” approach cannot address this problem, or the needs of Medicare patients.
Just as we promised 50 years ago, Blue Cross and Blue Shield companies maintain their commitment to the success of this landmark program. By working together, we can sustain and improve Medicare for the next half-century.
Scott Serota is president and CEO of the Blue Cross and Blue Shield Association based in Chicago.
