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Blue Shield of California

Blue Shield of California

Affordable, quality healthcare for Californians.

Oakland, California, USA

Blue Shield of California is a non-profit health plan, established in 1939 by the California Medical Association, dedicated to providing high-quality, affordably priced healthcare to Californians. As a mutual benefit corporation, it caps net income at 2%, returning excess earnings to members and the community, while actively transforming its technology infrastructure with cloud computing and data integration.

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How We Help

Problem Statement

Providing Californians with access to high-quality, affordably priced healthcare.

Core Technology

Cloud computing (Microsoft Azure), data integration (Experience Cube Data Hub for near real-time data), real-time processing (real-time claims payments with OODA Health/Cedar), customized telemedicine systems, statewide health information exchange.

Key Differentiators

Non-profit mission and '2% Pledge' (capping net income at 2% and returning excess to customers or community), focus on affordability and value (driving down prescription costs, improving health data systems), extensive networks and accessibility (large PPO and HMO networks statewide, BlueCard® national network, telehealth), commitment to quality and innovation (Accountable Care Organization program, modern health ecosystem), diversity, inclusion, and customer service, local focus and market share leadership in California Medicare Supplement (Medigap) policies, BlueSky program for youth mental health, Enhanced Care Management for Medi-Cal members, integration of mental health services into primary medical care via the Collaborative Care Model, and a strategic focus on becoming a technology-driven healthcare company.

Clinical Focus

Maternity, joint replacement, spine care, end-of-life care, cancer screening, mental health, and substance use disorders.

Target Customers

Californians (individuals, families), employer groups, Medi-Cal members, and those seeking Medicare Supplement (Medigap) policies.

Product Stage

Mature

Company Info

Business Model
Non-profit health plan, mutual benefit corporation (B2C and B2B for individuals, families, employer groups, government programs).
Founded
1939
Website
blueshieldca.com

Categories

Other

Disease Areas

Technologies

cloud computingMicrosoft Azuredata integrationExperience Cube Data Hubreal-time processingtelemedicinehealth information exchange

MedStartr Index Score

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26

What do you think of Blue Shield of California?

A HUGE part of what early stage companies, and even late stage ones, need and get on MedStartr is honest feedback from actual patients, clinicians, hospital leaders and industry insiders. It is very easy to get tunnel vision as a founder. Please tell the team that runs this company what you think.

Innovation

Clinical Benefit

Feasibility

Scalability

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