Excellus BCBS reports 2020 income, top executives’ salaries

Rochester’s Excellus BlueCross BlueShield on Friday reported a 43 percent decline in net income for 2020. The health plan also reported its top three executives’ salaries, which totaled nearly $6 million last year.

In fiscal 2020, the health plan reported $6.2 billion in premium revenue, with net income of $97.2 million, a $73.6 million decline from $170.8 million in 2019. The full-year results amount to a net income of $68.40 per member for the entire year, down from $113.87 per member in 2019.

Christopher Booth
Christopher Booth

“No one has ever faced a year like 2020,” Booth said in a statement. “The COVID-19 crisis required a strong and comprehensive response to assure our members were able to receive the care they needed and to help assure the health care system itself would survive. The pandemic devastated the economy and sickened tens of thousands of upstate residents.”

Booth noted that the organization took concrete steps to help members, provider partners, employer groups and brokers cope with the challenges created by COVID-19.

“We also reached out to local community organizations with financial support and resources to help them address real community needs,” he added.

During 2020, Excellus BCBS addressed the community needs resulting from the COVID-19 pandemic through financial support including:
• $102 million to pay for increased telemedicine coverage and increased provider reimbursement rates;
• More than $40 million in cash advances to providers approved beyond the normal $192 million in advances;
• $1 million in grants to hospitals for COVID-19 testing supplies and personal protective equipment;
• $250,000 in grants to hospitals for COVID-19 testing machines;
• $1.5 million in grants and sponsorships for locally-based health-related initiatives;
• $51 million to cover the cost of suspending prior authorization reviews, clinical editing programs and claim filing requirements;
• $3 million to cover the mandated increase in reimbursement for COVID-19 hospital admissions;
• $600,000 in grants to community-based food banks and pantries;
• $50,000 to support local domestic violence prevention organizations;
• $30,000 in grants to local diaper banks;
• $17.6 million in medical premium refund credits to large employers;
• $3.4 million in dental premium refund credits to employers; and
• $200,000 in grants for “return-to-work” kits for employers.

Total membership in the health plan grew by more than 13,000 during 2020, the fourth consecutive year membership has grown. Excellus BCBS has a total membership of 1.5 million. More than 95 percent of the Upstate New York population has some form of health coverage by private insurance or government-sponsored programs according to the latest reported figures from the U.S. Census Bureau.

Last year, Excellus BCBS’ rate increase request for 2021 in the individual market was 87 percent lower than the state average of all insurers and its rate increase request for small groups was 61 percent lower than the state average, the nonprofit organization noted.

“For the past four years, the health plan’s rate adjustments in the individual and group markets were far below the state average requests by other health plans,” Booth said.

Last year, Booth earned $3.26 million, while Chief Administrative Officer and General Counsel Stephen Sloan earned $1.41 million. The health plan’s Chief Financial Officer Christopher Gorecki’s salary was $1.1 million in 2020, according to the report. Booth is slated to retire on May 1. He will be succeeded by James Reed, regional president in the Central New York market.

Excellus BCBS paid $530.5 million in federal and state taxes in 2020, including $112 million for the federal tax to pay for the Affordable Care Act. The company’s reserves were $1.2 billion at the end of 2020, or the equivalent of 70 days of claims and expenses.

“The health plan spent more than $5 billion, or an average of $14.2 million every day, covering the health care cost for our 1.5 million members,” Gorecki said.

The federal government’s latest quality ratings have awarded the Medicare Advantage programs from Excellus BCBS with some of the highest ratings in the state, officials said. Medicare awarded the organization with 4.5 stars out of a possible 5-star rating for its Medicare Blue Choice HMO plans and its Medicare PPO plans. For the fifth year in a row, the Medicare Part D prescription drug plan from Excellus BCBS received a 5-star rating, the highest rating possible.

“This continues to be a well-run health plan and the company’s performance reflects that,” said Marianne Gaige, chairwoman of the health plan’s board of directors. “As a taxpaying nonprofit, our business helped our communities through the pandemic and assured members of access to coverage. We continued to offer competitively priced health plans and those products were recognized for their high quality. We also achieved a financially responsible margin to assure the company continues as a major partner for health care providers and a major employer in upstate New York.”

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Excellus BCBS CEO to retire; successor named

Excellus BlueCross BlueShield and Lifetime Healthcare Cos. Inc. President and CEO Christopher Booth plans to retire on May 1, 2021. He will be succeeded by James Reed. the announcement is part of a planned succession for executive leadership of the $6 billion nonprofit health plan.

Christopher Booth
Christopher Booth

“In addition to his knowledge and talent, Chris’ commitment to building a strong corporate culture and having an engaged workforce has led to measurable improvements in business performance,” said Chairwoman Marianne Gaige. “The system of Lifetime Way values and the seven-block strategy focusing on operational excellence and stakeholder satisfaction are a testament to Chris’ vision and will serve this organization well for years to come.”

Booth has led Excellus BCBS since January 2013.

“When I took this job, I said it was an honor to lead such a talented workforce of people who provide care and coverage for their neighbors,” Booth said. “I’m incredibly proud of all of our employees, our senior leadership team and the remarkable corporate culture we have built together. That culture is built on collaboration, cooperation and communication. It is what’s helped us navigate successfully through a multi-year transformation of our claims systems, the implementation of the Affordable Care Act and the launch of innovative partnerships with local health care providers.”

Jim Reed
Jim Reed

Reed joined the organization in January 1996 and most recently served as executive vice president of marketing and sales, and as regional president in the Central New York market. He was responsible for line of business oversight and all marketing and sales functions for the commercial group markets, retail markets, Univera Healthcare and Lifetime Benefit Solutions. He also had oversight of the Health Care and Network Management division.

“Jim brings more than two decades of successful leadership within the organization to his new role and has been instrumental in helping shape the future of the company in today’s fast-changing and dynamic health insurance industry,” Gaige said. “Success starts with having the right people in the right roles. Jim is strategic in his approach, has a strong sense of mission and brings a wide array of experience to the job.”

Over the course of his career, Reed has been involved in the community through various nonprofit organizations. Reed serves on the board of directors for Centerstate CEO, the Greater Rochester Chamber of Commerce and HealtheConnections.

“Our focus remains on our organization’s primary mission of providing access to affordable, high-quality health care to as many people as possible,” Reed said. “As a locally based health plan, we have strong partnerships with those who provide care and those who pay for it and we want to build on that going forward.”

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Excellus BCBS expects to spend $162 million on COVID-19 response

Excellus BlueCross BlueShield expects to spend at least $162 million on its response to the COVID-19 pandemic, the organization said this week.

The health plan is directing more than $1 million in grants for testing supplies and personal protective equipment to Upstate New York hospitals and area health care workers. The company also is working with regional business groups to help employers and their employees return to work.

Christopher Booth, president of Excellus BlueCross BlueShield
Christopher Booth, president of Excellus BlueCross BlueShield

“No one has faced a public health crisis like COVID-19 in the almost 90 years that our health plan has provided coverage in Upstate New York,” said Excellus President and CEO Christopher Booth. “This crisis requires a strong and comprehensive response to assure our members are able to receive the care they need and to help assure the system will survive. The pandemic significantly impacted the economy, sickened tens of thousands of people and continues to threaten upstate health care.”

During the crisis, Excellus expanded access to telehealth, trained physician offices on how to use it and increased reimbursement to providers for those services. Officials said that allowed many local provider practices to continue to see patients using remote technology and replace lost in-office revenue.

The expanded coverage and increased reimbursement associate will cost at least $80 million in 2020, officials noted.

Excellus will absorb a $12 million reduction in Medicaid rates from New York State this year, rather than pass it on to providers. Restoring some Medicare fees for providers that had been cut at the federal level added $6 million in costs this year.

The health plan also took several steps to reduce the administrative burden on hospitals, which increased costs for the plan. That included suspension of prior-authorization reviews, clinical editing programs and claim filing requirements that will cost $51 million, as well as implementing the 20 percent increase in reimbursements for COVID-19 admissions required under new federal law, costing $3 million.

For members, Excellus absorbed the cost of member out-of-pocket expenses for the diagnosis and treatment of COVID-19, medically appropriate testing and the member cost-share for all telehealth visits. Those steps, the organization said, are adding roughly $9 million in costs this year.

The $162 million in unbudgeted spending is being funded through Excellus’ reserves, officials said, noting that the response is in addition to $192 million in cash advances the health plan had extended to most of the 70 upstate hospitals in its network prior to the pandemic.

“Our priority in this crisis continues to be taking care of the customer and making sure members have access to the care they been,” Booth said. “We are starting to see an increase in claims from the pent-up demand for elective procedures and routine care that may have been put off during the quarantine. We are also still bracing for a possible second wave in COVID-19 related costs later this year. We hope it doesn’t come. We must be prepared if it does and we are ready.”

[email protected] / 585-653-4021
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