MANAGED CARE REFORM: Would Be Costly, Blue Cross Says
The Blue Cross/Blue Shield Association of America said Friday "it has concluded that all of the major managed care reform measures pending in Congress could push most Americans into restrictive health care plans," CongressDaily reports. In particular, Mary Nell Lehnhard, the group's senior vice president, said, "Proposed requirements for gathering and making available treatment and outcome data on providers and individual doctors would create administrative burdens and cost pressures that could undermine preferred provider organizations." She said that "[a]s the more open access PPOs try to contain costs and meet new reporting requirements, they would come to look like more restrictive" HMOs. "We did not realize how big the cost bulge would be. This is no longer a cost issue. It is s product redesign issue," Lehnhard said.
One Size Does Not Fit All
Lehnhard "cautioned against imposing a 'very rigid, micromanaged'" data collection and reporting requirement on health plans. She noted that the "reporting requirements for the Medicare Plus Choice program established in last year's Balanced Budget Act would make participation by PPOs impossible, thereby denying many seniors a choice of coverage." Noting that health plans "themselves are often impossible to categorize, she said it would be impossible to design one data collection and access standard that works for them all." Lehnhard said, "The government wants to compare apples to apples. But it is not that simple. There are oranges and bananas and combinations of all of them out there" (Norton, 5/1).