Blue Cross plans helping corporate clients cut health costs

The Blue Cross Blue Shield Association on Thursday unveiled an expanded database that will help individual Blues, like Philadelphia's Independence, drill down into the cost of care for their corporate customers who have operations nationwide.

"We as Blues are taking seriously the challenge of, while maintaining our individual nature, being seen as a national player," said Daniel J. Hilferty, chief executive of Independence Health Group, parent of Independence Blue Cross.

The Blue Cross Blue Shield Association, whose members cover 105 million Americans, has maintained a claims database for a decade, and Independence has contributed for years.

But now all 36 Blue Cross companies are required to share claims data, which are converted into 1,600 common treatments and elective procedures - up from 300 previously.

The database, BCBS Axis, is not open to the general public, limiting its impact as a tool for broad price transparency. But it will expand the information available for now to the largest corporate customers of the Blues.

Independence will not immediately offer the service to all corporate customers. "We will start with a group of motivated national customers," said Somesh Nigam, IBC's chief informatics officer.

The goal is to boost the quality of analysis that can be done for companies.

Using a new interface, Independence will be able to quickly help a Philadelphia firm with a few employees in Virginia Beach, Va., get a better grasp of variations in its employees' bills, especially those for X-rays and other imaging.

BCBS Axis will let Independence consider all Blue Cross claims in that area to evaluate its customer's medical bills.

An Independence analysis found that the corporate customer with employees in Virginia Beach was paying an average of $220 for routine X-rays, while the average for the region was $100.

An analysis for an unidentified Philadelphia-based firm with 12,000 workers in 20 states found the client saving $3 million, or 5.7 percent of its $53 million annual costs, if procedures were done at average-cost facilities instead of above-average-cost ones.

These analyses are based on what are called "shoppable" categories of care, "where a consumer can actually make a choice, like an MRI or a hip replacement," said Nigam. "Obviously a lot of health care is not shoppable. If you have a heart attack or a stroke, that's not a shoppable event."

Kevin Robins, chief executive of the MidAtlantic Employers' Association, in King of Prussia, said employers always welcome tools to control health costs.

If a company learns its average cost for a knee replacement is 110 percent of the average cost in the area, "that's very relevant because then they can decide how they want to incentivize the employees to do something different," Robins said.

Longer term, Suzanne F. Delbanco, executive director of the nonprofit Catalyst for Payment Reform, would like to see even more inclusive databases. "Having these big data sets is really helpful," she said. But "it may be more helpful to have data sets that combine data from multiple payers, and not just the Blues."

hbrubaker@phillynews.com

215-854-4651 @InqBrubaker

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