Advocate, BCBS partner on new low-cost health care plan

Downers Grove-based Advocate Health Care and Chicago-based Blue Cross and Blue Shield of Illinois have partnered on a new low-cost health care plan that opened Sunday on the state public exchange.

The plan, BlueCare Direct, offers insurance with low monthly premiums and low out-of-pocket costs, although sample costs were not available in advance. It will be offered both on and off the Get Covered Illinois exchange, the official health insurance marketplace for individuals and families statewide. The new plan also is available for small group customers, said Opella Ernest, divisional senior vice president of health care delivery and chief medical officer for BCBS of Illinois.

BlueCare Direct offers access to Advocate's network, including 12 hospitals such as Good Samaritan in Downers Grove, Good Shepherd near Lake Barrington, Advocate Condell Medical Center in Libertyville and Sherman Hospital in Elgin. The member chooses a primary care physician to help navigate and coordinate the patient's care and to provide referrals to specialists.

While patients can do some window shopping now, open enrollment starts Nov. 1 and ends Jan. 31.

"What we believe is most notable, though, is the level of care members will have access to through the plan. Lower costs and high-quality care can, in fact, go hand in hand," said Lee Sacks, executive vice president and chief medical officer of Advocate Health Care.

Five years ago, BCBS of Illinois and Advocate signed an arrangement they said created the nation's largest Accountable Care Organization for patients. Both Sacks and Ernest declined to discuss any financial terms of this new deal for their companies.

In recent weeks, BCBS has been making changes to its insurance products, such as seeking to eliminate the PPO plan because it costs too much money to operate. It then would tout its existing BlueChoice plan as a lower-cost option. Yet many employers might continue to offer the PPO, according to reports.

The Affordable Care Act went into effect last year and is aimed at individuals and families who lack employer-provided health insurance. They can go to public exchanges, or marketplaces, to get insurance such as Get Covered Illinois.

Since the law went into effect, BCBS has boosted its workforce about 15 percent to handle those going on the exchange and other changes within the industry, said Ernest.

"We have the necessary tools and resources to support this new product," she said.