Blue Shield of California
Blue Shield of California is a not-for-profit health plan provider founded in 1939 and based in San Francisco, Calif. Blue Shield serves 25 percent of Covered California members in regions statewide.
Expanded network coverage
Blue Shield is now one of only two preferred provider organizations (PPOs) available in all counties and ZIP codes throughout California, with expansions in 2016 to provide coverage in all of Yuba, Sutter, Alpine and Monterey counties. Also in 2016, Blue Shield will replace its exclusive provider organization (EPO) offering with a PPO in the Northern, North Bay, Alameda and Central Coast regions (regions 1, 2, 6 and 9).
Accountable care organization
Blue Shield is collaborating with Dignity Health on an accountable care organization (ACO) program in six regions to deliver comprehensive health care services using a coordinated care model to improve the quality and affordability of care. As an example, each ACO location uses a coordinated care management model to help members with chronic conditions manage their health. A team of registered nurse care coordinators, social workers, pharmacists and health coaches work closely with the physicians to provide high-touch team-based care for patients with complex care needs.
Treatment Cost Estimator
Blue Shield’s online tools help its PPO members learn about more than 400 treatments, 1,600 procedures and 160 episodes of care. In consultation with their physician, these tools equip members with accurate information that can help them make the right health decisions for themselves and their families.
Blue Shield offers members who live in remote and urban areas a convenient way to see specialists throughout California, which can save time, expenses and the hassle of traveling far from home. Telehealth is a special collaboration between Blue Shield and Adventist Health that uses state-of-the-art technology to provide access to network specialist care and services for certain conditions. Local Telehealth offices throughout California offer a specialized telemedicine cart that includes a high-definition camera, diagnostic scopes and a vital-signs monitor to send accurate images and sound readings for a timely and accurate diagnosis. The connection is secure and encrypted to ensure privacy.