OAKLAND, Calif., (April 28, 2021) – Blue Shield of California today announced that it has provided more than $114 million in direct financial support to 244 healthcare providers during the COVID-19 pandemic. The funds are part of a $200 million Provider Financial Support Program that Blue Shield announced last April.
“The program has been successful in accomplishing what we intended,” said Sandra Clarke, chief financial officer and senior vice president for Blue Shield. “It has primarily helped small to mid-sized practices and hospitals in our network to rise above the financial turmoil created by the pandemic and meet their cash-flow needs after most elective care was postponed during stay-at-home orders in early 2020. Our members rely on these organizations and independent healthcare providers to get the care they need, and I’m happy Blue Shield was in a position to step up and help these providers get through this challenging time.”
Funding assistance for network providers is still available, according to Clarke, and providers can send an email to email@example.com for details and an application.
According to Clarke, many large hospitals and hospital systems were able to tap into federal funding options; Blue Shield’s program served as a financial lifeline for those who could not easily obtain federal relief funds.
The majority of requests for financial support, 89%, came from physicians and other practitioners; 8% came from hospitals or hospital systems; and the remainder was split between independent physicians’ associations (IPAs) and medical groups.
The program options include:
- Advance payments: Blue Shield provided funding to eligible providers as a pre-payment for future services to Blue Shield members. Following a six-month grace period, each provider has the option to repay the funds to Blue Shield directly or to offset the amount owed from new claims for member care over the subsequent 12 months.
- Value-based agreements: Blue Shield assisted providers to deliver value-based, rather than volume-based care. The health plan worked with some commercial providers to convert their existing fee-for-service agreements to value-based contracts that provide a consistent monthly base revenue stream that is less impacted by volatility in patient volume.
- Streamlined member payments: In collaboration with healthcare tech startup OODA Health, Blue Shield enabled providers to receive member payments (such as co-pays) more quickly through automation. Providers have been able to focus on caring for their patients instead of collecting co-pays from Blue Shield members.
Healthcare provider feedback
Blue Shield of California’s provider support program helped hundreds of providers get through the financial hardships of the pandemic. Here are a few of their testimonials:
Salinas Valley Memorial Healthcare System, Salinas
263-bed public healthcare district hospital; 2100 employees
“We were able to do so much, in so many ways with the support we received from Blue Shield,” said Augustine Lopez, chief financial officer. “It was important for us to protect and retain our entire workforce – doctors, nurses and other front-line professionals. We were able to reallocate these valuable human resources to expand our intensive care unit and go directly into the community with COVID-19 education and care. Additionally, we were able to quickly source and purchase PPE supplies and equipment, and we opened alternative COVID-19 testing sites to redirect the volume of patients coming to the emergency room. All of these actions enabled us to focus on our goal of saving lives and serving our diverse community,” he concluded.
Columbia Pediatrics Medical Group, Long Beach
28 healthcare professionals and employees
“The financial support we received from Blue Shield was immensely helpful,” said Kim Holford, practice administrator who managed the health plan’s provider funding program for CPMG. “We were able to purchase the PPE supplies we needed, and retain our staff, so that our service to young families and their children could continue uninterrupted. The patients who continued to visit us were grateful that we were available and that they could rely upon us. Even though we had periodic decreases in patient visits throughout the year, we were able to manage through those dips because of the safety net of support from Blue Shield.”
360 Behavioral Health, Chatsworth
1,500 full and part-time professionals
“Blue Shield’s program came at a time when the future was vastly uncertain and operational and financial projections had broad ranges from best case to worse-case results,” said Dan Cross, chief financial officer. “It gave us the peace of
mind that financially we were somewhat on solid ground, allowing us to devote more mindshare to operational issues. Today we are stronger, more organized, and in a better position for stable and systematic growth than we have ever been.”
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 Shield Association with over 4.5 million members, over 7,500 employees and more than $21 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 $150 million to Blue Shield of California Foundation in the last four years to have an impact on California communities.