Issue6 Light Left Crop Medicare

Medicare for the future

For decades, Blue Cross and Blue Shield companies have been at the heart of health care. From pioneering the very idea of health insurance more than 90 years ago, to being the health care partner to one in three Americans, we are proud that today more than 90 percent of Americans have health coverage through their job, the Affordable Care Act, Medicare or Medicaid. Part of our rich history is the unique role the Blue System® played when President Lyndon B. Johnson signed Medicare into law nearly 60 years ago.

Sizable infrastructure and computing power were needed to process the amount of data needed to turn the vision and hope of Medicare into a reality for the nation’s elderly. At the time, no other entity in the country was equipped to support the effort. So the government turned to Blue Cross and Blue Shield, and we were there.

In the first year of the program, more than 19 million people enrolled in Medicare. Nearly 5 million were admitted to hospitals as Medicare patients, with each hospital admission and visit requiring claims to be processed seamlessly among the patient, medical provider and federal government.

Community by community, Blue Cross and Blue Shield companies were there to help give birth to this innovation, and we have brought security and stability to millions of Medicare patients ever since.

Nearly six decades later, the 34 independent Blue Cross and Blue Shield companies are still partnering with the government and medical community to ensure that Medicare continues to innovate, so it can remain successful far into the future. 

Baby boomers are often known as the generation that changed America and, with 10,000 people turning 65 each day, Medicare must change with them.   

Still largely based on a payment system that rewards doctors, hospitals and other medical professionals for the volume of services they provide, Medicare must transition to one that pays doctors for quality, coordinated care that helps people get healthy faster and stay healthy longer. Medicare continues to move toward 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 around the country are at the forefront of health care delivery and payment reforms. Across the Blue System, more than 71 million members have access to care from more than 385,000 providers engaged in 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. These individuals 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 90 cents of every health care dollar spent treating patients with a 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 nearly 60 years ago, Blue Cross and Blue Shield companies maintain their commitment to the success of Medicare. By working together, we can sustain and improve this landmark program far into the future.



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