Transforming health care

Health Reimagined is Blue Shield of California’s strategy to transform the healthcare system. Our mission is to create a healthcare system worthy of our family and friends and sustainably affordable for all. Key focus areas for 2022 are:

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Pharmacy Care Reimagined

Prescription drug costs are rising, and Pharmacy Care Reimagined is our plan to curb this trend. We believe that every person should have safe, equitable access to sustainably affordable prescription drugs. We will achieve this vision by transforming the end-to-end prescription drug ecosystem, investing in personal, high-quality experiences for our members, providers and pharmacists, andactivating these strategies with investment in technology and data.

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Payment innovation

Blue Shield of California is working to revolutionize how we pay for healthcare services in support of a health system that delivers high quality care, lowers cost, creates an exceptional member and provider experience, and ultimately achieves optimal health and well-being for all Californians.

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Real-time claims

Our real-time claims initiative is enhancing the speed of claims processing from days to seconds. It increases transparency, trust, and choice in billing process by providing a clear and total view of costs so members have more control and flexibility to choose how they would like to pay.

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Personal health records

Personal health records offer members an accessible integrated, comprehensive, real-time digital health record. These provide a member with an integrated online medical record that layers their clinical history and personal preferences to optimize their health care plan. Members can maintain and manage their health information in a private, secure, and confidential environment.


 

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Virtual care

We are creating a differentiated experience fostered through care model that recognizes whole person care cannot be delivered homogenously. If we truly want to see better outcomes and meet members where they are, we have

to incorporate all of the channels by which they can access care, whether in-person or virtual.
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Community Health Advocates

Community health advocates are navigators of the health system and connectors with community resources that address member’s social needs.

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Health@Home

Health@Home is a smart, life-care product comprised continuum of primary and specialty health care and services provided outside of traditional clinical environments and enabled by data to support member and provider service and site decisions, improved quality, outcomes and satisfaction, and lower costs for Blue Shield and its members.

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Behavioral Health

 
Blue Shield is transforming delivery of behavioral health services focused on by solving for access (navigation + availability), and quadruple aim measures (member/provider satisfaction, quality, and cost efficacy). We are investing in core initiatives that streamline access to care, enhance care coordination, make us the health plan of choice for providers to integrate behavioral health into primary care, and offer robust upstream digital solutions.

Transformation from within

Founded eight decades ago, Blue Shield is a mission-driven, taxpaying nonprofit health plan, and we are transforming ourselves to deliver on the promise of Health Reimagined.

We are transforming our workforce

By retraining and redeploying our employees, we are enabling them to maximize their talents and skills to help reinvent health care for our customers.

We are reimagining how a health plan operates

We are transforming our operations to provide customer and member experiences that are transparent and in real-time.