Blue Shield of California
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[edit] Mission
To ensure all Californians have access to high-quality health care at a reasonable price.
[edit] General Information
Founded in 1939, Blue Shield of California serves the state of California. The company has an annual revenue of $7.5B and supports a total staff of 4,500 employees. The current President and CEO is Bruce G. Bodaken.
Blue Shield of California is a not-for-profit mutual benefit corporation and a wholly owned subsidiary of California Physicians' Service, Inc.
[edit] National Affiliation
Blue Shield of California is an independent member of the BlueCross BlueShield Association.
[edit] Mission and Values
As a not-for-profit health plan, Blue Shield is guided by their mission and values, which encourage innovation and enable them to be a catalyst for constructive change.
Their mission and values are embodied in their proposal to guarantee health coverage for all Californians, the first time a major health plan has called for universal coverage.
[edit] Accreditation
The National Committee for Quality Assurance (NCQA) recently awarded Blue Shield an "Excellent" rating for service and clinical quality for its HMO and Point of Service (POS) lines of business.
"Excellent" accreditation status is reserved for the best health plans in the nation and is only awarded to those plans that meet or exceed NCQA's rigorous requirements for consumer protection and quality improvement and deliver excellent clinical care. Review Blue Shield's NCQA Health Plan Report Card at www.ncqa.org.
[edit] Statistics and Financials
[edit] Membership (as of January 2006)
HMO: 1,300,000 PPO: 1,200,000 TRICARE: 500,000 Other: 300,000*
Total: 3,300,000
[edit] Provider Network (as of November 2005)
HMO, PPO Primary Care Physicians: 10,838 (HMO), 18,719 (PPO) Specialists: 18,677 (HMO), 42,828 (PPO) Total: 29,515 (HMO), 61,547 (PPO)
[edit] Hospital Network (as of November 2005)
HMO: 279 PPO: 344
[edit] Locations
Blue Shield has offices in Chico, Folsom, Fresno, Gold River, Irvine, Hemet, Lodi, Monterey Park, Orange, Petaluma, Redding, Riverside, Sacramento, San Diego, San Francisco, San Jose, Santa Barbara, Walnut Creek, Woodland and Woodland Hills.
[edit] History
- 1938 - California Medical Association House of Delegates creates California Physicians' Service (CPS) on Dec. 18 by a vote of 114 to 12.
- 1939 - Articles of Incorporation filed with the California Secretary of State on Feb. 2; CPS begins marketing service to the public on March 6. Coverage for first group commences two months later.
- 1940 - In first year of operation, 20,000 Californians subscribe and 5,000 physicians join the pioneer prepaid healthcare service plan.
- 1943 - CPS offers first health plan in the nation with coverage for pre-existing conditions under group programs.
- 1946 - CPS is a founder of the National Association of Blue Shield Plans (later renamed the Blue Cross and Blue Shield Association).
- 1949 - Individual and family health plan membership offered through non-group programs.
- 1950 - Company introduces first catastrophic coverage in the nation.
- 1959 - California Physicians' Insurance Corporation Life (since renamed Blue Shield of California Life & Health Insurance Company), a Blue Shield wholly owned life and disability insurance subsidiary, is formed.
- 1963 - Blue Shield launches experimental programs to provide post-hospitalization nursing home care.
- 1967 - Medicare supplement and small group programs introduced.
- 1968 - Eye care benefits covering exams, frames and lenses are introduced.
- 1984 - Blue Shield becomes the first health plan to cover a heart transplant.
- 1986 - Blue Shield initiates case management to help subscribers receive optional types of care for long-term illness.
- 1988 - Blue Shield establishes a health maintenance organization (HMO).
- 1996 - Blue Shield becomes the first health plan in California to offer online benefits and enrollment information.
- With Access+ HMOSM, Blue Shield becomes the first health plan in California to offer members direct access to specialists in their physician's medical group.
- 1997 - Blue Shield acquires CareAmerica, becoming the first to convert a for-profit HMO into a not-for-profit HMO.
- 1998 - Blue Shield offers IFP Online℠, the first online enrollment system for agents.
- Blue Shield launches mylifepath.com℠, an online health management tool.
- 2000 - Blue Shield offers a guided imagery program to pre-surgical patients, and becomes the first health plan to connect doctors and members online. California's first cross-border HMO, Access Baja, is introduced.
- 2002 - Blue Shield becomes the first health plan to propose statewide universal coverage.
- 2003 - CPIC Life is re-named Blue Shield of California Life & Health Insurance Company (Blue Shield Life).
- Active Choice is introduced, the first comprehensive Blue Shield health care product licensed by the California Department of Insurance.
- 2004 - Blue Shield celebrates its 60th anniversary and now serves 3.3 million Californians.
- In an effort to address rising hospital costs, a smaller network is created for CalPERS members that will save $30 million in hospital costs in 2005. A comprehensive provider network was established for TriWest Healthcare Alliance to care for military personnel, their families and surviving dependents under TRICARE.
- 2005 - Blue Shield becomes new HMO carrier for the California Correctional Peace Officers' Association (CCPOA) Medical Plan.
- 2006 - Blue Shield Class Action
- After a class action lawsuit alleged that Blue Shield engaged in unlawful, unfair and fraudulent business practices by modifying the risk tier structure of its individual and family health care plans, Blue Shield agreed on a settlement of $6.5 million on behalf of former and current Blue Shield subscribers residing in California. The settlement received overwhelming support from the class members. The Honorable James L. Warren granted final approval of the settlement in March 2006.
[edit] External Links
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