Blue Cross Influence Grows in Boston as State Revisits Reform Debates

Originally published by the Center for Studying Health System Change (HSC) as a Community Report, 2005.

Blue Cross Influence Grows in Boston as Health Reform Debate Resurfaces

HSC researchers visited Boston as part of the Community Tracking Study and observed Blue Cross Blue Shield of Massachusetts expanding its influence in the local health care market at a time when the state was revisiting the debate over comprehensive health reform. The dominant insurer was leveraging its market position to negotiate with major hospital systems and physician groups, while state leaders were considering ambitious proposals to expand insurance coverage to the state's remaining uninsured residents.

Boston's health care market was shaped by the presence of world-renowned academic medical centers that competed intensely for patients, physicians, and research funding. This competitive environment drove both high quality and high costs. Health care spending in the Boston area remained among the highest in the nation, and employers expressed growing concern about premium increases that strained their ability to offer coverage. The renewed reform debate reflected frustration with the status quo and a growing sense that market-based approaches alone were insufficient to address the twin problems of rising costs and persistent uninsurance.

Sources and Further Reading

Center for Studying Health System Change, "Blue Cross Influence Grows in Boston as State Revisits Reform Debates," Community Report, Community Tracking Study (2005).