Blues' ventures often went awry Dubious projects hurt customers, regulators say

October 04, 1992|By Ann LoLordo | Ann LoLordo,Staff Writer

They call it Division W, but few at Blue Cross and Blue Shiel of Maryland know it exists. In a year and a half, the Blues have spent $12 million on the company president's pet project and have little more than planning documents and reports to show for it.

It is "off track and a muddle," a Blues consultant warns in internal company documents that also characterize Division W -- a project to speed claims processing electronically -- as "too ambitious."

To congressional investigators who questioned the financial stability of Maryland's largest health insurer, Division W is an example of the kind of technology experiment on which Blues management is too willing to spend precious premium dollars. It reflects President Carl J. Sardegna's penchant to explore a brave new world of health care options despite the potential cost to the Blues' 1.4 million customers, they say.

In a lengthy report on the Maryland Blues, the staff of the U.S. Senate Permanent Subcommittee on Investigations scrutinized the 29 Blues subsidiaries. Investigators discovered "a series of management decisions that confused regulators, hid corporate entities and in many cases lost policyholder money," the report says.

Since 1986, the Blues have lost at least $120 million on subsidiaries, which included health maintenance organizations, an arbitrage firm, a collection agency, pharmacies, and the international arm of a claims processing firm.

Along the way, the Blues' internal auditors alerted company officials to a series of questionable business practices at the three ventures aimed at capitalizing on new advances in technology: LifeCard International Inc., Health Line Inc. and Pertek Inc. There were allegations of impropriety and misuse of funds, questionable loans and insider deals. An employee of another subsidiary embezzled $4 million and financed gambling trips to Las Vegas and Atlantic City.

Mr. Sardegna, in recent testimony to the Senate subcommittee, defended the subsidiaries as an extension of the Blues' core business.

He conceded that Blue Cross "probably overestimated the pace and promise of technology" associated with several of the ventures. And while Mr. Sardegna acknowledged the company's multimillion-dollar losses from subsidiaries, he said it "is not unusual for a company our size" to invest $120 million over six years in what he called research and development.

The Blues say subsidiary officials who "abused" the company's trust were dealt with. Commenting on an $80 million loss from HMOs, Mr. Sardegna says the corporate parent "lost" because it was keeping HMO rates low.

And when subsidiaries faltered, Mr. Sardegna says, they were shut down or given new directions. "Today, the subsidiaries of BCBSM are profitable, have significant value and are helping to offset the rising costs of health care," the company said in a response to the Senate report.

Senate staffers, after a two-month review of company finances and management practices, reached a different conclusion: "After sinking millions upon millions into them, none of the subsidiaries have yet become the rising star executives had hoped for."

Rapid growth

In 1985, the organizational chart at Blue Cross and Blue Shield was relatively simple. The Blues had five subsidiaries, with for-profit business concentrated in two HMOs and a health plan administrator. The company ended the year with a $23.6 million surplus.

The arrival of Carl J. Sardegna in late 1985 preceded by several months the Blues' entry into the worst economic cycle in recent company history, a downturn that spanned at least three years. He sought to create new businesses to generate profits and to compete in a rapidly changing marketplace. At least 16 subsidiaries were formed in the ensuing six years.

As the Blues tried to lower costs by limiting health care options, the company reorganized its HMOs, expanded their services and acquired a third HMO. Meanwhile, the company sought to cash in on new technology and created subsidiaries to find new ways to process claims, serve providers and offer health care products.

But Senate staffers found "no clear long-term strategy" as the subsidiaries began to multiply. Subsidiaries formed their own subsidiaries, which had their own companies.

Some subsidiaries were created and never activated, such as Employers Compliance Services Inc. and Blue Employee Benefit Service Inc. The latter company was formed, the Senate report says, because a Blues executive "simply didn't like the name" of the former. The Blues invested $200,000 in the firms, even though neither became operational, according to Senate staff.

And there were several subsidiary officials who, company auditors later found, had engaged in questionable business practices. The companies they oversaw -- LifeCard International, Health Line and Pertek -- failed miserably. Between 1988 and 1990, internal and federal auditors identified several problems to Blues officials:

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