Blue Options Tiers Being Updated
We are updating the hospital and primary care provider groups tiering levels within our Blue Options plans.
The changes will go into effect for employer groups currently offering a Blue Options plan on the group's first renewal date on or after January 1, 2013 and for all new accounts on or after January 1, 2013.
If any of the hospital tier changes impact our Hospital Choice Cost Sharing feature, these changes will be implemented on account anniversary beginning January 1, 2013 on the same basis as noted above.
Why We Are Updating our Tiers
Periodic updating of our tiers with the most current available data is an important step in maintaining our tiered network plans as an affordable choice for more than 1,000 employers and 100,000 members who have our tiered plans. It also encourages providers in our network to continue to improve their cost and quality performance by reflecting these changes over time in the provider's tier.
The analysis of the data and the update to our tiers is based cost and quality methodologies that use well-accepted performance measurement principles and validated measures articulated by local and national physician leaders and measurement experts. This is our fourth re-tiering of the network and it reflects changes in the providers' data that have occurred since the last update. Future updates will occur on a regular basis.
Impact on Members
With the updated tiers, the cost that members would pay for care at some PCPs and hospitals will go up or down — depending on the providers' new tier.
We are currently in communication with providers about their underlying data results so that they have the opportunity to review it in advance and we expect to finalize each provider's tiering later this summer. We will communicate final and approved tier changes with employers and members, which we expect to be no later than October 1, 2012.
If you have any questions, please contact your Account Executive.