Kim Keck. Photo Credit: Blue Cross Blue Shield Association. Kim Keck (Credit: Blue Cross Shield Association)

The Blue Cross Blue Shield Association has named Kim Keck to take over as the organization’s chief executive officer Jan. 4.

Keck is the CEO of Blue Cross & Blue Shield of Rhode Island.

She will succeed Scott Serota, who has been with the Blue Cross Blue Shield Association since 1995 and has served as the association’s president since 2000.

(Related: Serota to Leave Blue Cross and Blue Shield Association CEO Post)

The association is a Chicago-based organization that represents 36 separate Blue Cross and Blue Shield companies.

The companies in the system range from Rhode Island Blue, a nonprofit carrier with 450,000 enrollees, up to Anthem, a publicly traded, for-profit carrier with 42 million health plan members.

Originally, Blue Cross plans were carriers that covered hospital services. Blue Shield plans covered physician services. Over time, most Blue Cross carriers combined with Blue Shield carriers, but, in some places, like California, one company has the rights to the Blue Cross name and emblem, and the other has the rights to the Blue Shield name and emblem.

One of the association’s sources of power is its ability to decide what organizations can use the Blue Cross and Blue Shield trademarks and logos, and where.

The association also helps the Blues negotiate with Congress and federal agencies.

Kim Keck

Keck has a bachelor’s degree in math from Boston College and a master’s degree in business from the University of Connecticut. She holds the Chartered Financial Analyst professional designation.

She spent 11 years at Aetna. While there, she served as the president of Aetna’s Northeast region, and later as president of its Southeast region.

She has been president of Rhode Island Blue since 2016.

She also has been a board member at Prime Therapeutics, a pharmacy benefits manager controlled by Blue Cross and Blue Shield carriers, and a board member at Oak Street Health, an accountable care organization that serves adults with Medicare coverage.

Rhode Island Blue has been an active participant in HealthSource RI, Rhode Island’s Affordable Care Act public health insurance exchange program.

The Gameboard

Keck’s predecessor, Serota, was in the rooms where both Republicans and Democrats happened to be drawing up health system change proposals from 1996 through 2010, when the two bills that created the Affordable Care Act package were signed into law.

Today, the Blues are dealing with the fact that COVID-19-related rules and turmoil led to big drops in health insurance claims in the second quarter of the year, but the possibility that the pandemic, and pent-up demand for care, could lead to an enormous in claims in the fourth quarter, or in 2021.

Several news organizations have reported that the Blue Cross Blue Shield Association has negotiated a $2.7 billion antitrust settlement, in a case involving allegations that Blues carriers worked together to limit competition and increase coverage prices.

Meanwhile, in some states, cash-strapped government agencies see Blues carriers’ formidable reserves as a possible source of program funding.

The Blues are also facing the possibility that federal health policy could stay about the same, or turn in any possible direction, starting in January.

As the CEO of the national Blues association, Keck will play a major role in shaping U.S. health care and health finance policy, whether that means shoring up the current Affordable Care Act-based system; moving to some kind of government-run health finance system; or throwing out the ACA and returning to a system based on the rules that were in effect in 2009, before the ACA came along.

— Read David Holmberg to Lead Blueson ThinkAdvisor.

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