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Q&A: A Payer CEO on the New Healthcare Market

Scott Mace, for HealthLeaders Media, July 3, 2012

Brad Wilson, BlueCross BlueShield of North Carolina: But one thing is clear. Regardless of the decisions of the employers, we are already moving toward a more individual, consumer-oriented marketplace. Whether the consumer is insured through their employer, or whether their employer discontinues the coverage and they will seek individual coverage through the exchange or through their own direct purchase opportunity, that's where we have been focused for the last two years, and that's where we're going to continue to focus, to be ready to meet the needs of whatever that market demographic may ultimately be. So I wouldn't say I was concerned. I would say that we will continue to be vigilant to try to determine what the market shifts are, and be prepared to offer the products and services that our customers, be they employers or individuals, need and want.

HealthLeaders Media: What is your reaction to the stock market sharp rise today in provider stock prices and drop in payer stock prices? … It seems the market is saying, good times for providers, challenging times for payers.

Wilson: One day does not a trend make, but it is in fact a data point. I would interpret that relative to the payer side, and again, recognizing that we are not for profit so we're not affected by that, but we do have investments. The market is expressing a concern that actually your first question raised. To what extent will individuals and employers comply with the law or choose to participate in the market. In other words, not pay the penalty, and that's a question mark. None of us know. It's still a projection. I'll digress just a minute and say that here in North Carolina, we believe that January 1, 2014, will introduce 2 million new people in North Carolina to healthcare coverage of some type. Approximately 850,000 being new Medicaid-eligibles, assuming that North Carolina chooses to comply with the law with the nuance of the court today.

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