Blue Cross Blue Shield Association Policy Solutions Could Lower Health Care Costs by $767 Billion

Affordability Solutions for America’s Health focus on increasing competition, lowering
prescription drug costs, and prioritizing high quality care

WASHINGTON, January 24, 2023 /PRNewswire/ — Today, the Blue Cross Blue Shield Association (BCBSA) released a policy solution that could reduce health care costs in United States of America by $767 billion over 10 years. Recommendation, Affordability Solutions for America’s Healthaddress the root causes of rising health care costs by promoting competition, lowering prescription drug costs, and prioritizing quality care.

The reason for this affordability crisis is clear: rising prices for health services and prescription drugs. According to the Health Care Cost Institute, health care prices will increase from 2016-2020 at roughly double the rate of general inflation – with price being the main driver of higher health care spending. In 2021, the average premium for an employer-provided family health insurance policy $22,221—a third of the average household income.

Rising costs for consumers are a significant consequence of rising prices for health care delivery. As hospitals continue to acquire physician practices, the result is often that they use reimbursement to expand revenue and drive higher prices. In addition, drug prices are rising due to high launch and list prices, and drug manufacturers are delaying generic and biosimilar drugs to market. Families are feeling the effects of higher prices every day through higher premiums and out-of-pocket costs. This is because the cost of health insurance is driven by the cost of health care.

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“We need to ensure that everyone has access to quality health care without breaking the bank,” said BCBSA President and CEO Kim Kek. “Rising prices for prescription drugs and medical care are leading to higher premiums and out-of-pocket costs. BCBSA has led efforts in the private market to make health care more affordable, but policy action is needed. It has reduced costs by more than three-quarters of a trillion dollars by improving competition, fixing drug prices, and improving the care patients receive.

BCBSA Affordability Solutions for America’s Health focus on:

  • Improve competition among health care providers by promoting reasonable reimbursement depending on the site of care, eliminating anti-competitive behavior, and implementing policies that promote fair and transparent billing practices.
  • Increase access to low-cost prescription drugs by speeding generic and biosimilar alternatives to market, eliminating pricing tactics that slow generic drug production, closing patent and regulatory loopholes, and providing consumers with more information on pricing.
  • Ensuring patients receive the highest quality health care by shifting from a fee-for-service payment model so that providers are rewarded and reimbursed for providing safe and quality care, as well as modernizing the prior authorization process so that providers can make appropriate and cost-effective treatment decisions with their patients.
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Over 10 years, the solution will generate federal savings $337 billionwill reduce personal insurance premiums by $298 billionand will save enrollees in Medicare and private plans $206 billion at out-of-pocket costs.

Making health care more affordable for all Americans requires not only good public policy but also private market solutions. The Blues are leading the way in partnership with CivicaRx to bring low-cost prescription drugs directly to consumers, including producing insulin at patient prices $30 or less per vial-storage nearly $400 for uninsured and underinsured patients.

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In addition, BCBSA and Blue Cross and Blue Shield joined forces this month to launch the Synergie Medication Collective, a first-of-its-kind approach that prioritizes partnerships and transparency to increase capabilities, accelerate innovation, and increase efficiency in managing medical costs. drugs are beneficial, such as chemotherapy to treat cancer or infusions to treat autoimmune diseases.

“We remain committed to working with industry and government to build a better and more affordable healthcare system,” Keck said.

About Blue Cross Blue Shield Association

The Blue Cross and Blue Shield Association is a national federation of 34 independent, community-based and locally operated Blue Cross and Blue Shield companies that together provide health care coverage to one in three Americans.

RESOURCES Blue Cross Blue Shield Association


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