2025 Mission Report
Creating a personal, high-quality experience
Blue Shield of California is advancing foundational changes to the system to make health care more affordable, transparent, and easier for members to navigate.
Expanded availability of biosimilar prescription drugs
Biosimilars are an effective way to lower drug costs without compromising quality. Since announcing Pharmacy Care Reimagined in 2023, we’ve expanded direct contracting with drug manufacturers to increase biosimilar access. Building on our success with Humira, we introduced a Stelara (ustekinumab) biosimilar this year for autoimmune conditions. Through formulary readiness, provider education, and aligned pharmacy pathways, we are accelerating adoption of lower-cost options while supporting consistent clinical outcomes.
Access to the lowest cost insulin available
Over the past few years, Blue Shield has joined other Blue Cross Blue Shield plans (“Blues”) to develop and distribute lower-cost biosimilars nationwide. This year, Blue Shield joined CivicaScript to expand access to lower-cost insulin: $55 for 5 pens. The initiative — recognized by the state as “$11 insulin” for Californians through CalRx — supports transparent pricing and nonprofit manufacturing to ensure stable, predictable costs for members who rely on insulin every day.
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Blue Shield of California Joins CivicaScript in Lower-Cost Insulin Offering
Prior authorization reform for simpler health care
Blue Shield committed to new actions to simplify and modernize the prior authorization process, including clearer member communications, more standardized electronic submissions, and commitments to reduce prior authorization requirements over time. These efforts build on Blue Shield’s broader Prior Authorization Reimagined work, aimed at reducing administrative burden for providers and helping members receive timely care without avoidable delays.
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Blue Shield of California Announces Actions to Simplify Prior Authorization Process
A strong provider network to protect affordability
Access and affordability go hand in hand. Blue Shield continued year-round negotiations with hospitals and medical groups across California to maintain broad access to care while pushing for prices that are fair and sustainably affordable for our members and customers. As a nonprofit health plan, we negotiate on behalf of our members and customers— evaluating quality, performance, and cost. Our goal is to ensure our members have meaningful choices within a high-quality provider network while helping to contain rising healthcare costs in order to keep premiums as affordable as possible.
Standing behind evidence-based preventive care
Preventive care remains one of the most powerful tools to protect health and control costs. We reaffirmed our commitment to covering evidence-based immunizations and supporting California’s science-driven vaccine policy. By aligning coverage with expert clinical recommendations, Blue Shield helps ensure members continue to have access to preventive care that protects individual and community health.
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Statement on California Vaccine Policy