Blue Shield of California
|Founders||California Medical Association|
|Headquarters||San Francisco, California|
|Key people||Paul Markovich,
President and chief executive
|Revenue||$8.898 billion USD (2008)|
|Net income||$307 million USD (2008)|
Blue Shield of California is a not-for-profit health plan provider founded in 1939 and based in San Francisco, California. The organization serves over 3.4 million health plan members and nearly 65,000 physicians across the state. Blue Shield of California was founded by the California Medical Association.
Blue Shield of California, then known as California Physicians' Service, was created by the California Medical Association on December 18, 1938, and was incorporated on February 2, 1939. The organization began offering coverage on March 6 of that same year. In 1946, the organization was among a founder of the National Association of Blue Shield Plans, which later became the Blue Cross and Blue Shield Association. Today, Blue Shield of California is an independent licensee of the national association.
The Blue Shield of California health plan was the first in the nation to offer catastrophic coverage in 1950, provide coverage for a heart transplant in 1984, offer online benefit and enrollment information in 1996, and offer an online enrollment system for agents in 1998. In 2006, the National Committee for Quality Assurance, commonly referred to as NCQA, recently recognized Blue Shield as an "excellent" health plan for service and clinical quality.
In 2010, Blue Shield of California, Dignity Health, and Hill Physicians Medical Group formed an Accountable Care Organization that covers 41,000 individuals in the California Public Employees Retirement System (CalPERS). During its first 2 years, this program reduced inpatient use and health care costs significantly.
In 2006, Blue Shield agreed to a $6.5 million settlement relating to its alleged modifying of the risk tier structure of its individual and family health care plans. In 2008, the organization agreed to a settlement with the California Department of Managed Health Care to resolve allegations of improper rescission of individual health plan coverage. Blue Shield agreed to pay $3 million as a penalty. The organization reinstated coverage to 450 members whose plans had been cancelled and agreed to provide compensation for any medical debts incurred by these policyholders due to the rescission.
Quality of care
In the California Healthcare Quality Report Card 2009 Edition, Blue Shield of California received 3 out of 4 stars in Meeting National Standards of Care and 2 out of 4 stars in How Members Rate Their HMO.
- "Accountable Care Organization Featuring Shared Global Risk Stimulates Development of Initiatives To Improve Care, Reduces Inpatient Use and Costs". Agency for Healthcare Research and Quality. 2013-05-08. Retrieved 2013-05-09.
- "2 health insurers to pay $13M to Calif. regulators". AP/Google. 2008-07-18. Retrieved 2008-07-18.
- State of California - Health Care Quality Report Card 2009 Edition