Home Industries Health Services Blue Cross & Blue Shield of R.I. reports $26M loss in 2023

Blue Cross & Blue Shield of R.I. reports $26M loss in 2023

By

Katie Castellani

-

04/10/2024

BCBSRI (1) — AS MEDICAL and pharmacy claims surged last year, Blue Cross & Blue Shield of Rhode Island reported a $26 million operating loss in 2023, down from the $21 million profit the insurer posted last year.

PROVIDENCE – As medical and pharmacy claims surged last year, Blue Cross & Blue Shield of Rhode Island reported Wednesday a $26 million operating loss in 2023, down from the $21 million profit the health insurer posted last year. The drop comes as Blue Cross reported a rise in medical and pharmacy claims that led

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PROVIDENCE – As medical and pharmacy claims surged last year, Blue Cross & Blue Shield of Rhode Island reported Wednesday a $26 million operating loss in 2023, down from the $21 million profit the health insurer posted last year. The drop comes as Blue Cross reported a rise in medical and pharmacy claims that led costs to grow by $195 million, or 10.5% over last year. But with administrative cost reductions and success on the insurer’s investments, Blue Cross reported a $602,000 net gain on a margin of 0.1% of revenue in 2023, Blue Cross said. “Here in Rhode Island, as well as nationally, health care costs are growing rapidly, driven by steep increases in utilization and expanding usage of high-cost pharmaceuticals,” Blue Cross CEO and President Martha L. Wofford said in a statement. “In the midst of these escalating cost pressures, [Blue Cross] sustained significant operating losses, but managed to break even financially. Even more importantly, we delivered the highest quality service to our members, grew our membership, and worked toward improving the affordability, accessibility, quality and equity of health care in Rhode Island.” Monthly payments to providers for member care and treatment rose by $16 million to $152 million in 2023 as health care costs rose to account for 89.3% of every premium dollar paid, Blue Cross said. Annual claims expenses for hospital-administered drugs, medical and surgical services, imaging and diagnostics also grew by $85 million over the previous year, Blue Cross said. Along with this, Blue Cross said pharmaceutical claims grew by $75 million in 2023, driven by a 1,300% increase in the commercial market’s use of some GLP-1 drugs for weight loss and diabetes. At the same time, use of high-cost specialty medications for autoimmune diseases rose by 20% as there was an expansion of conditions approved to be treated by the drugs. Blue Cross also reported its medical enrollment grew 2.3% in 2023 to cover more than 431,000 members, which is around 10,000 more than 2022. Also, Blue Cross dental saw a 4.5% rise in enrollment to 159,000 covered members. Blue Cross says it will release more information on its financial performance later this month through the 2023 Mission Report. Katie Castellani is a PBN staff writer. You may contact her at Castellani@PBN.com.