By the numbers: healthcare coverage
Since 1945, we’ve been focused on making health care more affordable for our members. Advocating for affordability is one of the primary ways we live our mission: peace of mind through better health. Here’s a snapshot of our members’ experience in 2024 and how we supported them every step of the way.
Claims processed in 2024
Members with BlueCross coverage
Commercial health plan claims requiring prior authorization
Virtual care visits
Claims costs we paid for our members
Behavioral health visits
Understanding and addressing health equity
We continue our commitment to elevate and address health disparities among our members. Using claims, self-reported and public data, our health equity report looks at the social risk factors that affect Tennesseans and their health outcomes.
About our health equity report
Our health equity report gives us a better picture of the health issues and barriers faced by our members and all Tennesseans. And this guides our work to more effectively partner with healthcare providers to address those issues. Applying our understanding of the data helps us promote better health for all our members, taking into account their unique circumstances.
Continuing our focus on mental health
Physical health and mental health are inseparable. In 2024, we continued expanding our member outreach programs to improve mental health outcomes and reduce medical events.
Virtual care: A valued standard in accessible health care
Member use of Teladoc Health®, our virtual care service that integrates with our BCBSTN mobile app, continues to increase. This virtual option ensures members have access to convenient, quality health care without having to leave home.
Putting our members first
Niaomi Woody, health navigator, on the call with a Dual Special Needs Plan member, knew something wasn’t right when the member seemed confused and was having difficulty continuing the conversation. Niaomi’s supervisor contacted 911 while Niaomi kept the member on the line.
“I thought this member must be afraid. I reassured her that she was going to be fine, that I wouldn’t leave her, and that help was on the way,” Niaomi said. “The thought that went through my mind throughout the call was, ‘I don’t want this person to feel alone.’”
Niaomi Woody
Health Navigator, BlueCross
Health planners drive preventive and chronic care member engagement
We sent customized health planners to more than 1 million members to highlight preventive screenings, immunizations or chronic condition care needed. These planners help make sure members get the preventive care they need and get support for any chronic health conditions they’re living with. More than 14% of our members with chronic health conditions are engaged with our support efforts.
Member health planners distributed
A new hospital option joins Network S
Chattanooga-based employers have been asking us to help manage the rising costs of care. So we asked local hospital systems to compete for a spot in our high-value network. Parkridge Health System delivered the most compelling bid for costs and quality, and they joined Network S on July 1.
Lower price for Network S
compared to Network P plans
Medicare Advantage 4.5‑star rating
Our Medicare Advantage PPO plan earned an impressive 4.5 quality rating from the Centers for Medicare & Medicaid Services (CMS) in 2024, marking the fourth consecutive year the plan has scored 4.5 or higher. The score is based on a 5-star rating system that reviews our operations, customer surveys and enrollees’ health outcomes.
Distinct performance and quality measures that Medicare Advantage plans with prescription drug coverage are evaluated against by the CMS
Meet our people
Cicily Maddox, case manager at BlueCross, recognized a serious health issue one of her Medicare Advantage members was experiencing while on the phone with her and worked to get it addressed quickly. Cicily ensured the member’s doctor appointment was moved up so she could be seen quickly and then worked to get her the home health support she needed.
She followed up often with the member because “people can be overwhelmed when dealing with serious conditions – I wanted to hear what she retained and what I might need to explain.”
Cicily Maddox
Case Manager, BlueCross
Serving students with sensory challenges
As part of its community investment plan, BlueCare Tennessee established three sensory rooms across the state in 2024, which join a sensory room created for Chattanooga’s Wolftever Creek Elementary in 2021.
These rooms offer a safe space for individuals to relax, refocus and manage sensory overload, and they provide particular benefits for students with sensory processing issues. By supporting these sensory rooms, BlueCare provides essential resources, aiding more than 250 students in managing sensory challenges and enhancing their academic performance and social interactions.
Months to receive a bachelor’s degree in computer science and potential job offer through BlueSky Institute’s partnership with ETSU
BlueSky Tennessee Institute model takes off
Our groundbreaking workforce development program to address a nationwide technology skill shortage graduated its first cohort in 2024. All 27 eligible graduates were hired for competitive roles within our own IT division.
Taking flight with BlueSky Institute
Abdulai Bah, a recent graduate of the BlueSky Tennessee Institute and new BlueCross employee, shares his thoughts on the program. “I recently graduated college from BlueSky Tennessee Institute and started my full-time job as an associate software engineer at BlueCross. That educational experience prepared me for the challenges and opportunities ahead, not just in the corporate world, but in life too.”
Abdulai Bah
BlueSky Tennessee Institute Graduate and new BlueCross employee
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BlueCross BlueShield of Tennessee, BlueCross BlueShield of Tennessee Health Foundation, BlueCross BlueShield of Tennessee Community Trust and BlueCare Tennessee are Independent Licensees of the Blue Cross Blue Shield Association. BlueCross BlueShield of Tennessee is a Qualified Health Plan issuer in the Health Insurance Marketplace.
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