Looking for a leader who could help it navigate an increasingly technology-centered health care world, CareFirst BlueCross BlueShield yesterday tapped the head of an electronic claims-processing firm to be its new president and chief executive officer.
Chester "Chet" Burrell, 60, is currently chairman and CEO of Indianapolis-based RealMed Corp., which provides claims services for insurers - including CareFirst - and doctors. He previously founded and led Novalis Corp., a health technology and consulting firm. He's also familiar with the Blue Cross world, having served as an executive of Blues plans in New York and Indiana.
He takes over the state's largest health insurer Dec. 1. Burrell could not be reached for comment yesterday, either at RealMed or through CareFirst.
In announcing the appointment, Michael R. Merson, chairman of CareFirst's board, said improvements in technology are a "pillar" of CareFirst's strategic plan. CareFirst's competitors, such as UnitedHealthcare and Aetna, Merson said, are already moving aggressively in that direction.
"Health information technology is a major frontier," said Jonathan Weiner, professor of health management and policy at the Johns Hopkins University's school of public health.
"What will distinguish the winning companies from the others is their ability to move beyond bill-paying" into such areas as secure individual medical records, reporting on the quality of doctors and hospitals, and clinical decision support, Weiner said.
CareFirst's current technology has run into some high-profile trouble lately. The company conceded that its highly touted "consumer-directed" plan, designed to reduce premiums by offering coverage with high deductibles, wasn't tracking deductibles properly, causing members to be billed for services that CareFirst should have paid for.
Also, the insurer was fined $125,000 this week by the Maryland Insurance Administration for being late in its claims denials more than 17 percent of the time. In its report on CareFirst claims problems, the MIA noted that CareFirst is using three different claims systems, the oldest (and the one with the highest error rate) dating from 1981.
"It's no secret that CareFirst has had separate IT platforms that don't connect and don't function properly," said Calvin M. Pierson, president of the Maryland Hospital Association.
Pierson, whose organization has often been at odds with CareFirst, will now be dealing with an old friend.
