Independence Blue Cross Competition
Now Viewing Independence Blue Cross's competition in: Managed Healthcare (primary)
Call Preparation Questions
Customers, Marketing, Pricing, Competition
Are the company's plans accredited by national organizations, like the National Committee for Quality Assurance (NCQA)? - Accreditation is a voluntary, but useful, marketing tool.
What proportion of revenue is from large employer, small group, and individual plans? - Small group and individual plans have historically been more profitable, but more difficult to assemble.
Does the company use a sales force or independent agents to sell its plans? - Large companies use a variety of sales channels.
Does the company use historical or anticipated costs to establish necessary premium rates? - State insurance commissions often require the use of historical costs.
Does the plan reward physicians who maintain standard levels of care at below-average costs? - Plans try to achieve a balance between encouraging physicians to keep costs low and allowing doctors to have control over their treatment decisions.
How much has the company raised employer premiums in the past year? - Employer premiums have increased more than 120 percent since 2000, according to the Kaiser Family Foundation.
Competitive Landscape
Demand for health insurance products is driven by the rising costs of medical care. The profitability of individual companies depends on efficient operations and the ability to negotiate favorable contracts with healthcare providers. Large companies and organizations have advantages in negotiating contracts with healthcare providers. Small companies can compete successfully by providing special coverage plans as part of government programs such as Medicaid, or for specialized populations. The industry is highly automated and capital-intensive: annual revenue per employee is close to $1 million.
Business Challenges
CRITICAL ISSUES
Healthcare Reform - Pending federal healthcare legislation could have an enormous impact on the managed healthcare industry. Competition from a proposed government-insurance plan could result in more competition but also smaller profits or even losses for existing companies. Companies could also no longer have the option to exclude customers with pre-existing conditions, thus requiring companies to insure patients with potentially expensive medical needs. However, if the federal government mandates that all consumers must have insurance, medical costs could fall because everyone, including healthy consumers, would pay into the system.
Rapidly Rising Healthcare Costs - National healthcare expenditures are expected to continue rising by more than 6 percent year over year from 2008 to 2018. Spending topped about $2.5 trillion in 2008, or about 16 percent of the US' gross domestic product (GDP). Private healthcare spending accounts for about $1.2 trillion, or about half the total amount. Overall healthcare spending includes doctor visits, hospital stays, prescription drugs, and other products and services.
Industries Where Independence Blue Cross Competes
- Health Care
- Health Care Services
- Health Care Plans(primary)
- Prescription Benefits Management
- Health Care Services
