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Blue Shield of California Invests in Innovative Technology to Advance Real-Time Claims Payments

Blue Shield of California Invests in Innovative Technology to Advance  Real-Time Claims Payments

SAN FRANCISCO (September 19, 2018) – Blue Shield of California and OODA Health, a San Francisco-based technology startup, will collaborate to build a new, cloud-based software platform to provide real-time claims payments to health care providers immediately after they deliver care to patients.

Blue Shield and OODA Health plan to roll out the new technology as a pilot program with Dignity Health and Hill Physicians in Oakland. As part of the collaboration, Blue Shield is providing a $1.5 million equity investment to OODA Health, which announced earlier today that it has successfully raised $40.5 million in its Series A fundraising round. Blue Shield’s ownership stake in OODA Health may increase pending the results of the claims payment pilot project.

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“When it comes to payment, leaving the doctor’s office or hospital should be like checking out of the grocery store. Everything is settled when you walk out the door,” said Paul Markovich, President and CEO, Blue Shield of California. “Creating this capability will dramatically improve the experience of members, physicians and hospitals.”

For Blue Shield, the investment in, and collaboration with, OODA Health is the nonprofit health plan’s latest effort to invest in initiatives to bring the health care system into the digital age, supporting efforts to improve quality while making the cost of care sustainably affordable.

“At OODA Health, our vision is a healthcare system liberated from waste and focused on delivering affordable and high-quality care through collaboration and real-time interactions,” said Seth Cohen, president, COO, and co-founder, OODA Health. “We believe that the payer environment is changing, and we bring the digital DNA and technological capabilities that will enable payers and providers to work together in a more collaborative manner.”

In June, Blue Shield announced a $30-million commitment to a major new collaboration with the California Medical Association (CMA). They will launch two pilot projects in Monterey and Butte counties to develop a new technology infrastructure to help physicians focus their attention on care delivery, rather than administrative work. The goal is for Blue Shield and CMA to scale the projects statewide with a focus on supporting independent physicians.

Earlier this year, Blue Shield announced it is taking steps toward providing its members access to patient-centered care by expanding its suite of home-based care programs. The health plan is collaborating with Landmark Health to bring comprehensive care to the homes of people suffering from multiple chronic conditions, and Blue Shield’s nationally-recognized in-home palliative care has recently been expanded to serve all 58 California counties.

Also this year, Blue Shield and Gemini Health announced a new Drug-Cost Transparency ServiceTM for prescribers and patients that provides real-time, patient specific cost information on their prescriptions and alternative drugs during the doctor visit.

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About Blue Shield of California
Blue Shield of California strives to create a health care system worthy of our family and friends that is sustainably affordable. We are a not for profit, independent member of the Blue Cross Blue Shield Association with care for four million members, 6,800 employees and more than $17 billion in annual revenue. Founded in 1939 and headquartered in San Francisco, Blue Shield of California and its affiliates provide health, dental, vision, Medicaid and Medicare health care service plans in California. The company has contributed more than $500 million to Blue Shield of California Foundation since 2002 to have an impact on California communities.

For more news about Blue Shield of California, please visit www.news.blueshieldca.com.

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About OODA Health

OODA Health was founded by a team of seasoned healthcare entrepreneurs who envision a healthcare system freed from an estimated $400 billion in waste. The company’s mission is to transform healthcare administration by enabling real-time interactions between providers, payers and members. Using a collaborative and innovative approach, the company enables stakeholders to eliminate billions of dollars in waste and dramatically improve the payment experience for members. For more information about OODA Health, please visit www.ooda-health.com.