Buckle Up BCBS: Part II
Here we go again.
Another article that made me roll my eyes.
Actually, this one angered me more than the first.
Here it is:
https://www.bizjournals.com/triangle/news/2025/08/14/blue-cross-nc-ceo-health-carereckoning.html
This time, Dr. Sotunde, CEO of BCBS, tells us that a healthcare reckoning is here.
He explains that a “seismic shift” is happening because of both rising costs and questionable motives.
The good doctor (I am assuming he is a good doctor, but it sounds like he’s spent more time as an administrator) goes on to explain Blue Cross Blue Shield’s plan of action.
This plan of action includes buzzwords like partnerships, collaboration, and accountability. He mentions improving the BCBS website so patients can find prices. He talks about reducing administrative burdens and having navigation teams.
Oh, good lord, where do I start?!
In the real world, the healthcare reckoning started decades ago.
Want to talk rising costs? A BCBS patient of ours was going to be charged $465 for a Rx that only costs $40.
Questionable motives? Of course. Health Insurance CEOs making millions of dollars?
I sure do question their motives.
Partnerships and collaborations? Those drive costs up and choices down.
An improved website? This is what I got when I tried to search what a basic EKG would cost a BCBS patient. At our office that EKG costs $0.
Again, I think Dr Sotunde got it wrong.
BCBS should buckle up.
Direct Primary Care has already avoided the seismic shift.
Thanks for finding the articles and enlightening us
Quote from Dr Sotunde
“Second, for any action we contemplate, we’ll ask the question: Does this lower costs for members or raise them? We’ll hold ourselves and others accountable for any actions that add unnecessary strain on families and business.”
So they are just now concerned about costs? What about the last 40 years (enjoyed the windfall)?
United Healthcare is no better. I’ve spent the better part of 6 hours trying to get a PA for an MRI from a real person. I keep getting told by the automated phone tree to go to their website and submit it on a “provider” portal. I learned by going through the various phone tree iterations that if I said I would participate in a survey after the call I could lower the wait time from >30 minutes to 8-10 minutes. All calls eventually ended up at the automated message telling me to go to the website before hanging up on me. Well, I tried to do that, but despite me sending in all of my pertinent information (tax ID, licenses, proof that I have a clinic that is where it says it is, etc.), I cannot have a portal account UNTIL I submit a claim to them for that tax ID. I’ve now sent emails to my Congressmen about it.
Advice to you Kimberly and to all DPC docs: if and when you can talk to a medically naive “customer service” rep and especially a “peer to peer” (Ask for that level of contact early in the salvo), let them know that YOU are recording the call too , AND that with your patient’s permission you will share it with the media, the state department of insurance, and advise your patient to share it on social. Oh and make sure you share it on your practice social too. We must fight tyranny aggressivel!
On the call ask the doctor’s credentials if it’s a so called “peer”, what their license number is in the state you’re in, if you can arrange an appointment for the dark side sellout to evaluate your patient, etc. Be incredulous at the absurdity and insulting nature of the whole charade.
Become a part of the righteous resistance! It’s a growing one. And best of all, the exercise is a) uniformly effective the more you shave them…somewhere inside they know they’re part of something very immoral…and b) it’s cathartic and healthy to have the upper hand over evil! Patients and potential patients will appreciate and applaud your defense of what’s right!
Ugh
utter waste of time. have them just pay cash .
Oh geeze. I made it a practice to ask patients about drug payment. I’d sometimes get, “I’m paying X-hundred dollars for this drug through my insurance.” I’d come back with, “Don’t go through insurance, it’s on the $4.00 list at Wal-Mart or whatever pharmacy I was monitoring online.” It happened and I was shocked at the time how patients were being screwed to the n’th degree by the insurance companies. Their CEO’s need to roast in the place where the Devil lives!!