We recently learned that Vermont Blue Cross Blue Shield would like to merge its operations with Michigan Blue Cross. This is alarming news, and our Department of Financial Regulation should not allow this merger to take place. Vermont is a small state and Michigan is a very big one. What happens when these two Blues merge? Most likely, Vermont BCBS will start to make use of Michigan Blue’s automated coding review and claims denial technology, which eliminates the need for medical staff to review claims, and which Vermont Blue currently lacks.

Who will lose out? Vermont patients. As information from Vermont’s patients is fed into Michigan’s computers, we can expect more claim denials. Nationwide, private insurers are profiting by using such automated claim denial technology, but who pays? The patients do as they will increasingly find coverage for necessary medical care denied not by medically trained human beings but by “algorithms.”

Ellen Oxfeld

Middlebury