A CASE STUDY of OhioBlueCross BlueShield of Ohio (BBO), headquartered in Cleveland, OH was an early pioneer of pre-paid health insurance. As part of the “Blues,” BBO was one of its most successful organizations, serving the Ohio region since 1934 and capturing more than $2 billion in revenues on an annual basis. In 1999, BBO was renamed Medical Mutual of Ohio. Today, its 2,500 employees help insure more than 2.6 million people throughout the state. While BBO had enjoyed a leadership position within the Blues network for many years, the organization was beginning to struggle as it attempted to expand market share and realize a significant competitive edge against new health plans entering its territory. By 1995, rising administrative expenses and steady increases in health care c

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