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Blue Cross of
California has been serving the health insurance needs of
California residents since 1937.
Blue
Cross of California, together with its branded
affiliates, provides health care services to more than 6.8
million members.
Offering a full
continuum of product and coverage options, Blue Cross provides
customers with unparalleled choice and flexibility in meeting
their health plan needs. These options are continually
fine-tuned to enhance access to affordable, quality health care.
The Company, with its strong track record for innovation,
focuses on progressive products and services designed to improve
the health status of all Californians. Unique product offerings
available in the
individual health insurance,
small
group health insurance, large group, senior
and
Medi-Cal markets include a full range of
integrated medical and specialty products.
Further to our
support of the Blue Cross and Blue Shield Association, Blue
Cross of California is committed to lifting the quality of
public debate on issues that affect health care coverage.
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Corporate
Profile
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History
of the
Blue
Cross
and Blue
Shield
System
1929 A
Baylor
University
administrator
set out
to make
health
care
affordable
for
everyone.
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By
creating
a
local
hospital
pre-payment
plan
for
public
school
teachers,
Justin
Ford
Kimball
made
medical
coverage
available
to
the
general
public
for
the
first
time.
The
idea
quickly
attracted
nationwide
attention.
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1936 The
Great
Depression
had
taken
its toll
on the
American
people
and
health
care was
virtually
unaffordable.
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A
group
of
humanitarians,
including
Ritz
E.
Heerman
and
Howard
Burrell,
lobbied
for
legislation
to
authorize
and
govern
hospital
service
plans
in
California.
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Health
care
would
be
made
affordable
for
Californians
through
the
Associated
Hospital
Service
of
Southern
California
and
the
Alameda
County
Medical
Association.
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1939 The
Blue
Cross
symbol
was
adopted
by a
commission
of the
American
Hospital
Association
as a
national
emblem
for
plans
that met
certain
guidelines
in
covering
hospital
care.
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The
first
Blue
Shield
plan
was
founded
in
California
in
the
same
year
to
cover
physicians'
services.
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1941
World
War II
changed
many
facets
of
American
society.
When
soldiers
returned
home
both
families
and the
economy
grew.
Blue
Cross
was able
to
provide
Americans
with
added
medical
and
surgical
coverage.
By the
end of
the
1940s,
35
million
Americans
were
Blue
Cross
subscribers.
1950
Blue
Cross
thrived
by
improving
benefits,
increasing
enrollment,
cutting
operating
costs
and
building
reserves.
1960 The
1960s
brought
very
important
changes
to the
Blue
Cross
organization.
In 1965
President
Johnson
signed a
bill
which
created
Medicare
and
Medicaid.
Blue
Cross
was
elected
by most
hospitals
to
process
the
Medicare
and
Medicaid
claims.
The
addition
of this
government
program
doubled
the size
of Blue
Cross
plans.
1970 A
combination
of
inflation
and
rising
health
care
costs
during
the
1970s
caused
Blue
Cross to
raise
premiums,
which
caused
alarm.
The
price of
malpractice
insurance
also
increased
dramatically,
and the
providers
of
insurance
had to
compensate.
1980
This was
a period
of
dramatic
growth
for Blue
Cross,
and in
1982
Blue
Cross of
Northern
California
and Blue
Cross of
Southern
California
became
one.
Blue
Cross of
California
was born
because
the two
plans
had
become
very
similar
and the
advances
in
technology
made
consolidation
a
practical
option
to
increase
efficiency.
1990 As
the
health
care
industry
continued
to grow
in the
1990s,
Blue
Cross
found it
must
learn to
prosper
in a
buyer's
market.
Customer
satisfaction
became
Blue
Cross of
California's
number
one
priority,
and it
remains
so
today.
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Focus
on
Quality
Health
care has
become
more
promising
while at
the same
time
more
complicated
and
confusing.
Consumers
not only
are
dealing
with
issues
of
access
and
affordability,
but also
with
questions
about
quality.
At
Blue
Cross of
California,
we are
committed
to
improving
health
care for
all of
us. And,
that
means a
focus on
quality.
We use
an
integrated
approach
to
improving
quality
of care
and
preventive
health
services.
We also
monitor
and
evaluate
medical
services
to seek
ways of
improving
them for
our
members.
It's
part of
what we
call
"The
Power Of
Blue."
National
Committee
for
Quality
Assurance
(NCQA)
Review
from
respected
outside
organizations
is an
important
part of
maintaining
plan
quality.
The NCQA
conducts
a
voluntary
review
process
to
evaluate
how well
a health
plan
manages
all the
parts of
its
delivery
system
in order
to
continuously
improve
health
care for
its
members.
We
actively
participate
in this
process
and have
implemented
programs
to
ensure
that we
continue
to meet
these
high
standards.
Quality
Management
Notifications
Member
Rights
and
Responsibilities
(English)
or (Español)
The
Health
Plan
Employer
Data and
Information
Set
(HEDIS)
We also
participate
in
HEDIS,
which
uses a
set of
indicators
determined
by the
NCQA to
consistently
measure
quality
of care
on an
annual
basis.
Medical
Group
Performance
Profile
We
developed
a
medical
group
report
card to
track
important
issues,
such as
patient
satisfaction,
access
to care,
health
screenings
and
problem
handling.
It's
part of
our
effort
to be
sure
that our
members
are
happy
with us,
their
doctor
and
their
other
providers.
Our
preventive
health
programs
are
designed
to help
members
improve
the
quality
of their
lives
through
information
on
healthy
living,
access
to
preventive
health
care and
care
management
for
chronic
conditions.
Publications
Our
newsletters
for
members
and
providers
share
up-to-date
information
on
healthy
living
tips,
practice
guidelines
and
current
health
initiatives.
Preventive
Health
Care
Guidelines
These
schedules
for
members
and
providers
recommend
screenings
and
immunizations
for
healthy
infants,
children,
adolescents,
adults
and
seniors.
Infant
and
Childhood
Immunization
Outreach
This
reminder
program
targets
parents,
pediatricians
and
medical
groups
to
promote
on-time
immunizations.
Health
Management
Programs
Qualified
members
with
diabetes,
asthma
and
congestive
heart
failure
receive
special
health
education
materials
and
learn
self-management
skills
to
promote
living
well
with
chronic
conditions.
Academic
and
Public
Partnerships
Blue
Cross of
California
collaborates
with
community
organizations
and
accredited
universities
on
various
clinical
research
and
development
projects.
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About
Health Net of
California
One of the largest provider networks in the
state
Health Net is one of the largest
health plans in
California. We have an
extensive network of more than 50,000
physicians, and 4,600 pharmacies - all
working together to serve more than 2.3
million members. You can use our Doctor
Search feature to see if your doctor or
physician group is listed in Health Net's
statewide care network.
NCQA accreditation
The National Committee for Quality Assurance
(NCQA) has awarded its highest accreditation
status of "Excellent" to Health Net's
commercial and
Medicare
lines of business. Excellent accreditation
status is awarded for service and clinical
quality that meet or exceed NCQA's rigorous
requirements for consumer protection and
quality improvement. HEDIS®* results are in
the highest range of national performance.
The NCQA is an independent, not-for-profit
organization that evaluates health plans'
quality.
Extra advantages
Depending on the Health Net plan you join,
you could take advantage of a wide array of
programs and services designed to help keep
you well. Here's just a select sampling:
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WellRewards**
This program offers discounts of 10% to
60% on many products and services
designed for your good health, including
eye exams, eyewear and contact lenses,
fitness club memberships, Jenny Craig®
and Weight Watchers® programs. Also,
save 30% on ongoing massage therapy,
chiropractic and acupuncture with
participating providers.
History of quality care
Health Net, Inc. is one of the nation's
largest publicly traded managed health care
companies. Its mission is to help people be
healthy, secure and comfortable. The
company's HMO, POS, insured
PPO
and government contracts subsidiaries
provide health benefits to approximately 6.4
million individuals in 27 states and the
District of Columbia through group,
individual, Medicare, Medicaid and TRICARE
programs.
Health Net's
behavioral health services subsidiary, MHN,
provides behavioral health, substance abuse
and employee assistance programs (EAPs) to
approximately 7.4 million individuals in
various states, including the company's own
health plan members. The company's
subsidiaries also offer managed health care
products related to prescription drugs, and
offer managed health care product
coordination for multi-region employers and
administrative services for medical groups
and self-funded benefits programs.
* HEDIS is a registered
trademark of the National Committee for
Quality Assurance. **The WellRewards program
offers discounts on health products and
reduced-fee health services. It is not part
of
Health Net
members' benefit programs and is not
intended to take the place of any covered
benefits and is offered to the members in
addition to, rather than instead of, covered
benefits. |
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About
Blue Shield of California |
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With 3.3 million members and $7.5 billion in
annual revenue,
Blue Shield of
California
is the state's third largest health plan. |
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Founded in 1939 and headquartered in San
Francisco, Blue Shield is a not-for-profit
corporation with approximately 4,500
employees and more than 20 offices
throughout California. |
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Fast Facts |
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Year founded: 1939 |
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Service area: California |
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Annual revenue: $7.5 billion |
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Total employees: 4,500 |
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Chairman, President and
Chief Executive Officer:
Bruce G. Bodaken |
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Blue
Shield is a California
not-for-profit mutual
benefit corporation. |
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National affiliation:
Independent Member of the
BlueCross BlueShield
Association |
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Parent company: California
Physicians' Service, Inc. |
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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. |
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"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. |
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A (stable) rating
from Standard and
Poors |
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A (excellent) rating
from AM Best |
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A (excellent) rating
by Weiss Ratings,
Inc. |
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HMO: 1,300,000 |
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PPO: 1,200,000 |
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TRICARE: 500,000 |
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Other: 300,000* |
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Total: 3,300,000 |
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*= Includes non-underwritten
ASO and National Accounts
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Type of Provider |
HMO |
PPO |
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Primary Care
Physicians |
11,027 |
18,516 |
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Specialists |
16,917 |
29,372 |
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Total |
27,944 |
47,888 |
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HMO: 304 |
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PPO: 351 |
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Blue Shield also has offices
in Chico, Folsom, Fresno,
Gold River, Irvine, Hemet,
Lodi, Monterey Park, Orange,
Petaluma, Redding,
Riverside, Sacramento, San
Diego, San Jose, Santa
Barbara, Walnut Creek and
Woodland |
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History |
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Blue
Shield of California's
60+-year history is
distinguished by innovations
that have changed the face
of health care and made us a
prominent force in the
California healthcare market. |
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1938 |
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California Medical
Association House of
Delegates creates California
Physicians' Service (CPS) on
Dec. 18 by a vote of 114 to
12. |
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1939 |
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Articles of Incorporation
filed with the Secretary of
State on Feb. 2; CPS begins
marketing service to the
public on March 6. Coverage
for first group commences
two months later. |
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1940 |
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In first year of operation,
20,000 Californians
subscribe and 5,000
physicians join the pioneer
prepaid healthcare service
plan. |
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1943 |
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CPS offers first health plan
in the nation with coverage
for pre-existing conditions
under group programs. |
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1946 |
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CPS is a founder of the
National Association of Blue
Shield Plans (later renamed
the Blue Cross and Blue
Shield Association). |
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1949 |
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Individual and family health
plan
membership offered through
non-group programs. |
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1950 |
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Company introduces first
catastrophic coverage
in the nation. |
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1959 |
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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. |
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1963 |
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Blue Shield launches
experimental programs to
provide post-hospitalization
nursing home care. |
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1967 |
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Medicare supplement
and
small
group programs
introduced. |
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1968 |
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Eye care benefits covering
exams, frames and lenses are
introduced. |
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1984 |
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Blue Shield becomes the
first health plan to cover a
heart transplant (Stanford
University, May 16, 1984). |
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1986 |
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Blue Shield initiates case
management to help
subscribers receive optional
types of care for long-term
illness. |
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1988 |
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Blue Shield establishes a
health maintenance
organization (HMO). |
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1996 |
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Blue Shield becomes the
first
health
plan in California
to offer online benefits and
enrollment information. |
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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. |
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1997 |
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Blue Shield acquires
CareAmerica, becoming the
first to convert a
for-profit HMO into a
not-for-profit HMO. |
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1998 |
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Blue Shield
offers
IFP OnlineSM,
the first online enrollment
system for agents. |
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Blue Shield
launches mylifepath.comSM,
an online health management
tool. |
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2000 |
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Blue Shield offers a guided
imagery program to
pre-surgical patients, and
becomes the first health
plan to connect doctors and
members online. |
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California's first cross
border HMO, Access Baja, is
introduced. |
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2002 |
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Blue Shield becomes the
first health plan to propose
statewide universal
coverage. |
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2003 |
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CPIC Life is re-named Blue
Shield of California Life &
Health Insurance Company
(Blue Shield Life). |
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Active Choice is introduced,
the first comprehensive Blue
Shield healthcare product
licensed by the California
Department of Insurance. |
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2004 |
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Blue Shield celebrates its
60th anniversary and now
serves 3.3 million
Californians. |
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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. |
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A comprehensive provider
network was established for
TriWest to care for military
personnel, their families
and surviving dependents. |
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2005 |
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Blue Shield becomes new HMO
carrier for the California
Correctional Peace Officers'
Association (CCPOA) Medical
Plan. |
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Blue Shield awarded San
Francisco Chamber of
Commerce's Excellence in
Business Award (EBBIE) for
its strong growth, string of
excellent ratings,
innovative products, policy
leadership and investments
in people and communities. |
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