Institute:Office of National Coordinator (ONC) Workforce Training Curriculum
Component:Introduction to Health Care and Public Health in the U.S.
Unit:Financing Health Care - Part 1
Lecture:Payors in the U.S. Health Care System
Slide content:Blue Cross/Blue Shield Independent, state-licensed organizations Blue Cross reimburses hospitals Blue Shield reimburses physicians Historically set up as not-for-profits under special state laws Today, some organizations operate as commercial insurers 12
Slide notes:Before continuing the discussion of managed care, Blue Cross Blue Shield is a special case that deserves separate mention. It is a collection of private insurance organizations, each of which is independent and licensed by a state. Blue Cross reimburses hospitals and Blue Shield reimburses physicians, but the two organizations function as a whole. Historically, Blue Cross Blue Shield consisted of not-for-profit associations organized to circumvent state insurance licensing requirements. Today, some Blue Cross Blue Shield organizations operate as commercial for-profit insurance companies. 12