News Center

Originally published in The Tennessean, March 2025

No matter where you enter the health insurance system, you likely pay some sort of premium and have a deductible – like you do with home or auto insurance.  

Drug and medical costs continue to rise, and use of medical services rose sharply nationwide in the second half of 2024. Claims for BlueCross BlueShield of Tennessee members totaled more than $18 billion last year. So, insurers like us are facing intense pressure from our customers to keep premiums low.

Depending on your benefits plan, your employer or the government may cover part of your premium

This premium is combined with others in your membership group and used to pay for that group’s health care needs.  

That’s why your cost could vary significantly from your neighbor’s and for some people, it could be a more significant part of their budget. As a health insurer, we understand these scenarios can be stressful and confusing.

This begs the question: what’s the value of health insurance if it’s not affordable? And what are we actually buying when we purchase health insurance?  

These are fair questions. That’s why it’s important to step back and take a closer look at how a health insurer is meant to advocate for you.  

Simply put, when you buy insurance, you’re ultimately buying financial protection against risk. The value is financial security in a catastrophic scenario. And today, it’s also found in our efforts to negotiate better prices for you and guide members to cost-effective care.

Nearly 80 years ago, BlueCross was built on providing financial protection against unexpected medical expenses

At the time many people struggled to afford their bill if they were hospitalized, so we offered a product to cover that large, unexpected expense. 

Since then, the company has added coverage for doctor’s visits, lab work and medications, but the commitment to providing financial security has remained unchanged. And we know this commitment promotes a sense of security and wellbeing, enabling people to thrive and contribute positively to their communities. 

This is one reason many employer groups buy health coverage for their employees. They want to support the physical and mental wellbeing of their workforce, and providing a compelling benefits package also helps with hiring, retention and overall productivity. 

Employers expect us to be good stewards of their dollars, and large employers are often paying the actual claims for their employees. They want to know the care they pay for meets evidence-based, clinical guidelines and that this care is being delivered cost-effectively. If we can’t manage claims costs on their behalf, they may have to reduce or eliminate offering benefits.   

Our role in the system is to make health care more affordable for our customers – that’s what they’ve hired us to do

Part of what employer groups and members pay for is access to a network of providers who have agreed to discounted rates in exchange for a higher volume of potential patients. Insurers are the ones who negotiate these discounts on behalf of employers and members. 

But we also work to make sure our members understand all their options for care, and which ones are most affordable under their plan.

For example, we help members make sure they have the right follow-ups after an inpatient hospital stay so they don’t have to go back. Or, we can help guide members to the lowest-cost, highest-quality provider if they need a joint surgery that might be difficult to afford. This advocacy portion of our work makes a difference in the lives of our members.   

At BlueCross, our job is to ensure we help our members and customers get the right care, at the best price.

If we don’t negotiate prices and if we don’t use evidence-based guidelines for what we cover, premiums will go up for everyone. So, we will continue being affordability advocates for Tennesseans.