The Impact of Blue Cross Conversions on Accessibility, Affordability, and the Public Interest

Milbank Quarterly

Volumn 81, Issue 4, 2003, Pages 509-542

  Hall, Mark A ^a,b   Conover, Christopher J ^a  

^a WAKE FOREST UNIVERSITY   (United States)

^b WAKE FOREST SCHOOL OF MEDICINE   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

HEALTH CARE COST; HEALTH CARE ORGANIZATION; HEALTH CARE POLICY; HEALTH INSURANCE; HEALTH SERVICE; LAW; PROFIT; REVIEW; TAX;

EID: 0346656491     PISSN: 0887378X     EISSN: None     Source Type: Journal    
DOI: 10.1046/j.0887-378X.2003.00293.x     Document Type: Review

References (50)

1. Accenture. 2002. Community Impact Analysis of the Proposed Conversion of Carefirst, Inc. to a For-Profit Business Entity and the Merger between Carefirst, Inc. and Wellpoint Health Networks, Inc. Wellesley, Mass. Available at http://www.disr.washingtondc. gov/information/carefirst/pdf.IStext.pdf.
2. Arnould, R.J., and L.W. DeBrock. 1985. The Effect of Provider Control of Blue Shield Plans on Health Care Markets. Economic Inquiry 23(2):449-76.
3. Arnould, R.J., and D. Eisenstadt. 1982. The Effects of Medical Society Control of Blue Shield on Fees in the Physician Service Market: Some Preliminary Evidence. Quarterly Review of Economics and Business 22(1):32-44.
4. Bainbridge, S.M. 2002. Corporation Law and Economics. New York: Foundation Press.
5. Blackstone, E.A., and J.P. Fuhr. 1998. Blue Cross: Health Insurance. In Market Dominance, edited by D.I. Rosenbaum, 175-93. Westport, Conn.: Praeger.
6. Blackstone Group. 2002. Analysis of Carefirst, Inc. Business Case. New York: Blackstone Group, L.P. Maryland Insurance Administration. Available at http://www.mdinsurance.state.md.us/documents/CFBusinessCasereportFinal12-02.pdf.
7. Blair, R.D., and R.J. Vogel. 1978. A Survivor Analysis of Commercial Insurers. Journal of Business 51(3):521-9.
8. Blustein, J., and E.C. Hoy. 2000. Who Is Enrolled in For-Profit vs. Nonprofit Medicare HMO's? Health Affairs 19(1):210-20.
9. Born, P.H., and C.J. Simon. 2001. Patients and Profits: The Relationship between HMO Financial Performance and Quality of Care. Health Affairs 20(2):167-74.
10. Bryce, H.J. 1994. Profitability of HMOs: Does Nonprofit Status Make a Difference? Health Policy 28(3):197-210.
11. Chollet, D.J., A.M. Kirk, and M.E. Chow. 2000. Mapping State Health Insurance Markets. Washington, D.C.: AcademyHealth.
12. Conning and Company. 2000. The Blue Cross and Blue Shield Plans: Past, Present, and Future. Hartford, Conn.
13. Conover, C.J., and M.A. Hall. 2003 (April). For-Profit Conversion of Blue Cross and Blue Shield of North Carolina: Assessment of the Potential Impacts on Accessibility and Affordability of Health Care. North Carolina Department of Insurance.
14. Cunningham, R. III, and R.M. Cunningham Jr. 1997. The Blues: A History of the Blue Cross and Blue Shield System. DeKalb: Northern Illinois University Press.
15. Cunningham, R., and D.B. Sherlock. 2002. Bounceback: Blues Thrive as Markets Cool toward HMOs. Health Affairs 21(1):24-38.
16. Delmarva Foundation for Medical Care. 2003. The Potential Effects of a Carefirst Acquisition by Wellpoint on Maryland Stakeholders. Easton, Md., February. Available at http://www.mdinsurance. state.md.us/documents/ DelmarvaFinalReport02-10-03.pdf.
17. Eisenstadt, D., and T.E. Kennedy. 1981. Control and Behavior of Non-profit Firms: The Case of Blue Shield. Southern Economics Journal 48(1):26-36.
18. Feldman, R., D. Wholey, and J. Christianson. 1998. Do Medicare HMOs Cost Shift? Inquiry 35:315-31.
19. Feldman, R., D. Wholey, and R. Town. 2003. The Effect of HMO Conversions to For-Profit Status. Available at http://www.mdinsurance. state.md.us/ documents/EffectofHMOConversions-Fina12-4-03.pdf.
20. Feldstein, P.J. 1999. Health Care Economics. 5th ed. Clifton Park, N.Y.: Delmar.
21. Fluegel, B. 2002. To Convert or Not to Convert? New York: Tillinghast Towers Perrin.
22. Foreman, S.E., J.A. Wilson, and R.M. Scheffler. 1996. Monopoly, Monopsony and Contestability in Health Insurance: A Study of Blue Cross Plans. Economic Inquiry 34:662-77.
23. Frech, H.E. III. 1976. The Property Rights Theory of the Firm: Empirical Results from a Natural Experiment. Journal of Political Economy 84(1):142-3.
24. Frech, H.E. III. 1980. Health Insurance: Mutual or Government. Research in Law and Economics (supp.) (1):61-73.
25. Frech, H.E. III, and P.B. Ginsburg. 1978. Competition among Health Insurers. In Competition in the Health Care Sector: Past, Present and Future, edited by Warren Greenburg, 216-43. Germantown, Md.: Aspen.
26. Friedman, E. 1998. What Price Survival? The Future of BC and BS. Journal of the American Medical Association 279:1863-9.
27. Grossman, J.M., and B.C. Strunk. 2001. Blue Plans: Playing the Blues No More. In Understanding Health System Change: Local Markets, National Trends, edited by P.B. Ginsburg and C.S. Lesse, 37-60. Chicago: Health Administration Press.
28. Hay, J.W., and M.J. Leahy. 1984. Competition among Health Plans: Some Preliminary Evidence. Southern Economic Journal 50(3):831-46.
29. Himmelstein, D.U., S. Woolhandler, I. Hellander, and S.M. Wolfe. 1999. Quality of Care in Investor-Owned vs. Not-for-Profit HMOs. Journal of the American Medical Association 282:159-63.
30. Iglehart, J.K. 1995. Inside California's HMO Market: A Conversation with Leonard D. Schaeffer. Health Affairs 14(4):131-42.
31. Kane, N.M. 1997. Some Guidelines for Managing Charitable Assets from Conversions. Health Affairs 16(2):229-37.
32. Kass, D.I., and P.A. Pautler. 1981. The Administrative Costs of Non-Profit Health Insurers. Economic Inquiry 19(3):515-21.
33. Kuttner, R. 1998. The Commercialization of Prepaid Group Health Care. New England Journal of Medicine 338(21):1558-63.
34. Landon, B.E., A.M. Zaslavsky, N.D. Beaulieu, J.A. Shaul, and P.D. Cleary. 2001. Health Plan Characteristics and Consumers' Assessments of Quality. Health Affairs 20(2):274-86.
35. LECG, LLC. 2003. Foundation Analysis, February 11, 2003. Available at http://www.mdinsurance.state.md.us/documents/ LECGFinalReport2-11-03-pdf.
36. McCann, R.W. 2003. Blue Cross - What Happened? In Health Law Handbook, edited by A. G. Gosfield, 725-99. St. Paul, Minn.: Thomson/West.
37. Mennemeyer, S. 1984. Effects of Competition on Medicare Administrative Costs. Journal of Health Economics 3:138-54.
38. National Association of Insurance Commissioners (NAIC). 2001. Statistical Compilation of Annual Statement Information. Kansas City, Mo. Available at http://www.naic.org/insprod/catalog_pub_ statistical. htm#ast_compilation.
39. Nudelman, P.M., and L.M. Andrews. 1996. The "Value Added" of Not-for-Profit Health Plans. New England Journal of Medicine 334(16):1057-9.
40. Price WaterhouseCoopers. 2002. Assessment of Market Impact of the Anthem, Inc. Purchase of Blue Cross Blue Shield of Kansas. Available at http://www.ksinsurance.org/consumers/bcbs/public_testimony/kid/ pwcmarket.pdf.
41. Robinson, J.C. 2000. Capital Finance and Ownership Conversions in Health Care. Health Affairs 19(1):56-71.
42. Robinson, J.C. 2003. The Curious Conversion of Empire Blue Cross. Health Affairs 22(4):100-18.
43. Schlesinger, M., S. Mitchell, and B. Gray. 2003. Measuring Community Benefits Provided by Nonprofit and For-Profit HMOs. Inquiry 40:114-32.
44. Schramm, C.J. 2001a. Blue Cross Conversion: Policy Considerations Arising from a Sale of the Maryland Plan. Baltimore: Abell Foundation. Available at http://www.abell.org/pubsitems/hhs_bluecross_1101.pdf.
45. Schramm, C.J. 2001b. Implications for Health Care Providers Resulting from the Sale of Kansas Blue Cross Blue Shield. Available at Intervenors/Kms/Statement_Schramm.Pdf (accessed February 12, 2002).
46. Strom, S. 2002. Blue Cross Assets in New York Benefit Health Care Union, Non Health Charities. New York Times, April 18, A26.
47. Tu, H.T., and J.D. Reschovsky. 2002. Assessments of Medical Care by Enrollees in For-Profit and Non-Profit Health Maintenance Organizations. New England Journal of Medicine 346(17):1288-93.
48. U.S. General Accounting Office (GAO). 1975. Performance of the Social Security Administration Compared with That of Private Fiscal Intermediaries in Dealing with Institutional Providers of Medicare Services. Washington, D.C.
49. Vogel, R.J., and R.D. Blair. 1975. Health Insurance Administrative Costs. Staff Paper no. 21. Rockville, Md.: Social Security Administration.
50. Wholey, D.R., R. Feldman, and J.B. Christianson. 1995. The Effect of Market Structure on HMO Premiums. Journal of Health Economics 14(1):81-105.