Blue Shield of California and CMA collaborate to build health care model of the future

June 12, 2018
Area(s) of Interest: Advocacy Practice Management 

Blue Shield of California and the California Medical Association (CMA) today announced a multi-year collaboration to develop and support a new health care model that gives Californians access to quality, comprehensive and sustainably affordable care that improves the health of individuals and their communities.

Blue Shield will invest $30 million to support the initiative, beginning with two pilot projects in Monterey and Butte counties designed to bring health care into the digital age, tie pay to value, and create a patient-centered experience through home- and community-based services. To achieve this, a new technology infrastructure will be built to help physicians focus their attention on care delivery, rather than administrative work. The goal is for Blue Shield and CMA to scale the projects statewide with a focus on supporting independent physicians.

The nonprofit health plan will work closely with CMA’s leadership and physicians in those local communities to build new models of care that will:

  • Bring health care into the digital age: Use the latest technology to create a real-time, automated environment, reducing physicians’ administrative burden and facilitating personalized health care for members (e.g., real-time transcription services that complete the electronic medical record on behalf of the physician without any additional data entry).
  • Tie pay to value: In collaboration with physicians and hospitals, identify clinical best practices and ensure health care providers are rewarded for using them (e.g., use best available testing to ensure the optimal treatment options are considered for cancer patients).
  • Create a patient-centered experience: Focus on all the factors that influence an individual’s health status including their housing, food security, transportation, social, emotional and physical well-being. Mobilize, organize and deliver a personalized solution for each patient so they have their best chance to live the healthiest possible life (e.g., establish a health care advocate who helps those in need receive the necessary support to optimize their health; home care for chronically and seriously ill patients; and shared decision-making with providers to choose the right care).
  • Improve physicians’ ability to practice: Greatly reduce the capital requirements and financial burdens on physicians as they move into value-based care and alternative payment models.

“Today’s announcement is part of Blue Shield’s ongoing effort to create a health care system worthy of our family and friends and sustainably affordable. We do this by collaborating with physicians, hospitals, clinicians and other health care leaders to put people at the center of the health care system,” said Blue Shield President and CEO Paul Markovich. “We are starting small but thinking big.”

“CMA is proud to collaborate with Blue Shield to bring California’s health care system further into the modern age,” said CMA President Theodore M. Mazer, M.D. “This innovative pilot project will utilize state-of-the-art technology to build a new health care model that expands and streamlines patient access to care while reducing administrative work. I would like to thank Blue Shield for recognizing the importance of investing in this effort to improve patient treatment, while reducing overwhelming administrative burdens, freeing physicians to be doctors rather than data entry technicians. We can, in this manner, create personal 21st century care.”

“This new pilot project will greatly improve patient care by utilizing technology to better meet the needs of patients in Butte County,” said former CMA President and Paradise Medical Group CEO Richard Thorp, M.D. “By streamlining administrative burdens for physicians and improving the delivery of high-quality care, this pilot project will enable physicians to focus more on treating patients rather than paperwork, and make it easier for small practices that serve rural areas to continue to provide care to our community.”

“The task for Clinica de Salud del Valle de Salinas and our partners is to increase access to quality health care at a price that is affordable for working families in Monterey County,” said Monterey County Medical Society President Maximiliano Cuevas, M.D. “This is an opportunity to work with our partners to explore putting in place a health care delivery system that removes the fragmentation of care that currently exists, and replaces it with a system that easily coordinates care between physicians, hospitals, emergency departments and social service agencies.”

For Blue Shield, this is the latest step in the nonprofit health plan’s ongoing efforts to transform health care.

Earlier this year, Blue Shield announced it is taking steps toward providing its members access to patient-centered care by expanding its suite of home-based care programs. The health plan is collaborating with Landmark Health to bring comprehensive care to the homes of people suffering from multiple-chronic conditions, and Blue Shield’s nationally-recognized in-home palliative care is now available in all 58 California counties.

Also this year, Blue Shield and Gemini Health announced a new drug-price transparency service for prescribers and patients that provides real-time, patient specific cost information on their prescriptions and alternative drugs during the doctor visit.


About Blue Shield of California
Blue Shield of California, an independent member of the Blue Cross Blue Shield Association, is a nonprofit health plan with 4 million members, 6,800 employees and more than $17 billion in annual revenue. Founded in 1939 and headquartered in San Francisco, Blue Shield of California and its affiliates provide health, dental, vision, Medicaid and Medicare health care service plans in California. The company’s mission is to ensure all Californians have access to high-quality care at an affordable price. Blue Shield has contributed more than $500 million to Blue Shield of California Foundation. Contact your local agent or broker about Blue Shield of California products and services or visit www.blueshieldca.com.

About California Medical Association
The California Medical Association represents the state’s physicians with more than 43,000 members in all modes of practice and specialties. CMA is dedicated to the health of all patients in California. For more information, please visit CMADocs.org, and follow CMA on FacebookTwitterLinkedIn and Instagram.



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