The impact of Blue Cross conversions on health spending and the uninsured.

Using statewide data on health spending and uninsurance rates, we investigate the impact of Blue Cross conversions on health care costs and coverage. We find mixed results, with some conversion states improving their performance on either or both measures relative to the national average and others experiencing a decline. A multivariate analysis suggests that overall, the impact of Blue Cross conversion may be to reduce hospital and total spending, but whether this effect endures depends in part on how "conversion" is defined. State policymakers and regulators might find these results useful in considering future Blue Cross conversions.

Duke Scholars

Author Jan Ostermann Duke Global Health Institute