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Blue Shield of California Health Reimagined Initiative to Transform Health Care for Individuals, Communities Throughout California

Innovative pilot programs focus on quality-driven, value-based care across the state; address health care inequities, challenges highlighted by COVID-19 pandemic
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OAKLAND, Calif. (June 16, 2020) – The newest generation of technology in physician offices, consumer-friendly digital apps to keep people healthier, a personalized approach to help patients find the services they need, and tying physician and hospital pay to quality and patient satisfaction – these are just a few offerings of Blue Shield of California’s Health Reimagined initiative, a comprehensive and ambitious effort to improve access to quality health care while making it more affordable.

The program uses the latest innovations and technologies, plus collaborations with medical providers, employers, community stakeholders and others to transform the healthcare system for individuals, families and communities.

Blue Shield, a tax-paying nonprofit health plan, has launched 20 pilot programs in four counties – Butte, Los Angeles, Monterey and Sacramento. The efforts range from a customized virtual-care system so patients can see their own doctor via smart phone, tablet or computer, to an Apple Watch-enabled virtual assistant that helps physicians create an electronic medical record with their voice, and settling all claims in real-time before the patient leaves the physician’s office or the hospital. 

This “real-time claims” initiative helps determine what Blue Shield owes clinicians and facilities as well as what the patient owes, thereby dramatically reducing the administrative burden on health care providers and consumers. Blue Shield now intends to make this service, which has been tested for months, available statewide to help generate better cashflow for hospitals and doctors’ offices facing economic hardship during the COVID-19 public health crisis.

“It is time for us to reimagine health care for everyone,” said Paul Markovich, president and CEO, Blue Shield of California. “This effort addresses long-standing access, equity, cost and quality issues that have been further exposed during the COVID-19 pandemic. We will create a health care system worthy of our family and friends and sustainably affordable through our Health Reimagined initiative.”

How Blue Shield is Transforming Health Care

The health plan is working closely with medical providers, local and regional stakeholders, and collaborating with technology firms to bring the best ideas and solutions to the market.

Blue Shield’s solutions cover three main categories:

  • Holistic health: Studies show that a person’s health and well-being are also influenced by social determinants outside the doctor’s office or the hospital. Blue Shield’s efforts include addressing a wide array of external issues such as access to healthy foods, transportation and behavioral support.
  • Personal care: Blue Shield believes in health care that places patients at the center. That means giving patients and their doctors tools, time and space to have meaningful medical visits and conversations so they can tackle tough health issues together.
  • High-tech, high-touch: Blue Shield is using modern technologies for patients and their doctors, such as a customized telemedicine system. The health plan also supports a statewide health information exchange for patient records so providers can have enhanced and efficient ways to deliver care.

In addition, Blue Shield is transforming within by reimagining how a health plan operates to create customer, member and provider experiences that are transparent and in real-time.

“With Health Reimagined initiative’s shared decision making tool, our providers are able to spend more time with their patients so they can make meaningful decisions together – with their preferences in mind – about their pregnancy care with focus on labor and delivery,” said Bruce Bob, M.D., FACOG, co-founder and administrator at Capital OB/GYN in Sacramento. “And with Blue Shield’s Community Health Advocate Program, we can now think about supporting the needs of the whole person and whole family to improve the health and wellness of our patients.”

Where Blue Shield is Transforming Health Care

Blue Shield has launched pilot programs in four regions of the state with specific demographics and collaborations in mind. They are:

  • In Butte County where access to care is an ongoing challenge for rural communities.
    • In collaboration with Paradise Medical Group, Blue Shield is making available next-generation services, including customized virtual-patient care via PMG Connect and virtual assistants for physicians via smart watches. PMG Connect has become an important tool for physicians during the COVID-19 pandemic, as physicians are able to treat their patients via virtual visits.
  • In Sacramento County in collaboration with large, well-established medical providers.
    • Blue Shield is working with Dignity Health and Hill Physicians Medical Group to test a new real-time claims payment system that aims to bring a “retail experience” to providers and their patients; and to offer “community health advocates” who provide personalized, in-home and high-touch support to patients.
  • In Monterey County with a large employer to help address primary-care shortage.
    • Blue Shield is collaborating with health care providers and companies to bring access to more primary care services in the region to help support Municipalities, Colleges, Schools Insurance Group’s (MCSIG) more than 11,000 members.
  • In Los Angeles County to help transform care delivery in this large and diverse metropolitan region
    • Through Blue Shield of California Promise Health Plan and our collaboration with local providers and well-known community-based organizations, we’re addressing the needs of under-represented and under-resourced communities.
    • Blue Shield Promise Health Plan is collaborating with L.A. Care Health Plan to build a network of community resource centers that will be a hub for promoting individual and community health.

In addition, in Washington D.C. and Sacramento, Calif., Blue Shield is promoting health reform and policy innovations that allow for healthcare transformations in the marketplace.

“Blue Shield is putting people at the center and designing better ways for them to receive access to care,” said Terry Gilliland, executive vice president, Blue Shield’s Healthcare Quality and Affordability. “These pilot programs are just the beginning. Our goal is to take the best solutions and quickly scale them across the state. By taking a comprehensive approach, together with all our stakeholders, we believe we can reimagine health care.”

For more information about Blue Shield’s Health Reimagined initiative, go to

About Blue Shield of California
Blue Shield of California strives to create a healthcare system worthy of its family and friends that is sustainably affordable. Blue Shield of California is a tax paying, nonprofit, independent member of the Blue Cross Blue Shield Association with over 4 million members, 6,800 employees and more than $20 billion in annual revenue. Founded in 1939 in San Francisco and now headquartered in Oakland, Blue Shield of California and its affiliates provide health, dental, vision, Medicaid and Medicare healthcare 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.

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