access
Coordinated Care Across the State and Across the Country Capabilities for Large and National Accounts
Visit us at mylifepath.com
across the state, HMO access to more than 280 hospitals and 24,000 physicians in California.
It Starts with Blue Shield of California California is the place we call home. It’s a place of lively commerce carried out by individuals with unique health and wellness needs. Across the state, Blue Shield of California provides access to a range of managed care products and services, supporting millions of members who choose their own paths. We are the clear choice for thousands of large employers.
PPO access to more than 365 hospitals and nearly 46,000
But if your business drives you across borders, you need a health plan to provide benefits where you need them. It starts with Blue Shield of California. You can turn to us for much more than a top plan across the state. Through our arrangements with other Blues plans we can coordinate access to health care across the country. Why should you choose us? Because we understand the unique needs of large and multi-state employers, delivering the access, service and credibility you’re looking for in a health plan.
physicians in California.
across the country
60-year heritage supporting the wellness of individuals.
Not-for-profit status, serving Main Street, not Wall Street.
One of the five financially strongest HMOs in the nation.1 Nationwide BlueCard access to 9,400 hospitals and 744,000 providers in all 50 states.
Chosen by more than 2.3 million members in California.
accessible
When you choose Blue Shield of California you gain access to one of the most extensive provider networks in the state. In addition to our medical networks, we can provide integrated ancillary networks for pharmacy, dental and vision benefits as well as options in short-term health and life through CPIC Life.速 Although availability varies by area, we can offer a broad range of benefits solutions to suit your needs.
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Gain Access to a Vast Network of Providers National network Network access doesn’t end at the state border. We also coordinate access to one of the largest national networks through our arrangements with other Blues plans and the associated BlueCard Program. In fact, 85 percent of all providers in the United States participate in the program.
Coordinating care abroad Outside the country, the BlueCard Worldwide Program secures access to care for members traveling abroad. Your employees will enjoy our relationships with more than 22,000 providers in 200 countries around
the world. We’ve also developed Access BajaSM HMO, the first California-based, cross-border health plan for employees to receive care in Mexico.
Locally managed for greater savings Beyond California, the key to our success is the local relationship each affiliated plan has with its own provider network. Our affiliated plans nationwide negotiate provider contracts at the local level. That translates to reduced costs for providers serving your out-of-state employees.
AVERAGE BLUE SHIELD OF CALIFORNIA PPO SAVINGS 2
65%
45%
Hospital
40%
Outpatient
Professional
In California, the average PPO provider savings that Blue Shield members receive is among the best of any Blue plan nationwide, translating to reduced claims costs for you.
LOWER COSTS THROUGH BLUECARD 3
1997
1998
1999
2000
Dollars saved
$15,800,000
$39,300,000
$80,500,000
$115,000,000
Number of claims
188,000
290,000
458,000
646,000
The immense size of Blue Shield and our affiliates allows us to negotiate deep provider savings on contracted rates nationally and pass them on to you. Over the past four years, savings have increased significantly for Blue Shield’s out-of-state member claims.
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Dedicated Service for Smooth Account Administration Account management To keep our promise of excellent service, we dedicate teams who focus on your needs, including: • Implementation of your account– offering on-site enrollment meetings and custom communication materials when appropriate. • Reporting capabilities that offer consolidated information and ad hoc reports to manage your benefit plan. Where applicable, our reporting capabilities meet standards set by the Health Plan Employer Data Information Set (HEDIS ® 4 ). • COBRA administration services to help you meet regulatory requirements in an easy, cost-effective way.
• Seamless claims processing, which completes 97 percent of claims on time with 98 percent accuracy. 5
improvement. For example:
• Experienced support teams, which set up accounts quickly and accurately.
• Inquiries are responded to with 99 percent accuracy.6
• Dedicated operations centers for large and national accounts.
• Group and member records are established during enrollment with virtually 100 percent accuracy.5
• Calls are answered within 30 seconds more than 83 percent of the time. 6
Member service Our customer service representatives know your plan options in detail. We empower our people with the authority to respond quickly and dependably, keep track of their results and constantly strive for
We also listen to what you’re saying through consortium and local customer satisfaction surveys. Results are used to place your priorities at the center of everything we do. As a result, our overall California HMO member satisfaction rate has steadily increased three years in a row, up 15 percent since 1997.7
FAVORABLE PERCEPTION INDUSTRY VS. BRAND 8
• Legislative updates on federal and state issues. • Regular assessments of plan effectiveness and long-term direction.
58%
56%
56%
Plan administration We understand that large and national employers have unique needs that are best met by integrating the administration of your plan through: • Electronic networking that links affiliated Blues plans nationwide.
4
40% Hotel
Computer Software
Auto
31% Health Insurance
Blues
Consumers have a favorable impression of the Blue brands almost 2 to 1 over the rest of the healthcare industry.
Everyone can provide customer service. But Blue Shield of California has the experience to understand the complexities of large and national clients. We structure our operations and service departments to deliver consistent and superior results.
supportive 5
trustworthy
Blue Shield of California was founded in 1939 by a group of physicians who believed in providing personalized care. That approach has been the key to our steady growth and stable presence for the past 60 years.
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Rely on a Credible Company with Adaptable Solutions Earned confidence So that we can continue to do great things in the future, we pay close attention to strong performance. Blue Shield of California is proud of its continued, demonstrated excellence in quality and financial security. During 2001, we again earned high ratings from independent benchmark firms: • “A-” rating from Weiss • “A-“ rating from Standard & Poor’s • “A-, Excellent“ rating from A.M. Best • “Commendable” NCQA accreditation for commercial products
Focus on wellness Our quality improvement and medical management programs continuously work to enhance the care and service your employees receive while monitoring your cost. Nationally, we offer Guided Imagery and LifeMAP programs to support recovery from surgery and prevent complications and readmissions. In California and some
other locations, we also offer disease management programs that teach your employees critical skills for managing their conditions. Contact us to see what is available in your area.
Flexibility to stay relevant We recently won Best of Blue Awards for our leadership in e-healthcare practices and system processes from the Blue Cross and Blue Shield Association. It’s our innovation that sets us apart from other health plans. Your employees can draw on us for personalized services that are attuned to today’s health. In California we launched an alternative health network, offering employees up to 25 percent discounts on acupuncture, fitness clubs, massage therapy and wellness classes they want.9 Employees nationwide can access even more convenient, timely resources through our award-winning Web site, mylifepath.com.10
BRAND AWARENESS AMONG OPINION-LEADERS 8
49% 10% Blues
Kaiser
8%
7%
4%
Aetna
United
Cigna
When business leaders want expert opinions on the healthcare industry, the Blues are top in mind share.
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make a move to Blue Shield of California
For access to healthcare benefits coordinated across the state and across the country, consider Blue Shield of California. Our superior networks and customer service are built to serve California companies in the global economy. Contact your local Account Executive, Account Manager or Inter Plan Coordinator to learn more. Or, visit our Web site at www.mylifepath.com.
1
Weiss Ratings, Inc., 2001.
2
Figures represent annual statewide average and are not guaranteed.
3
Actual BlueCard savings vary by group due to location.
4
HEDIS is a registered trademark of the National Committee for Quality Assurance.
5
Member Touchpoints Report, conducted by Performance Measurement on behalf of the Blue Cross and Blue Shield Association, Q3-4 2000.
6
Blue Shield of California, Consumer Operations Report, Q2 2001.
7
Blue Shield of California Customer/Competitor Strategic Indicator Study, Q2 2001.
8
Blue Cross and Blue Shield Association 2000 Annual Report.
9
Discount services from OneBody, Inc. (OneBody) are not a covered service of any Blue Shield health plan. OneBody credentials and manages the program’s practitioners. None of the terms and conditions of Blue Shield’s health plans apply.
10
2001 “Gold Award” in the Best Overall Internet Site category from eHealthcare Strategy & Trends.
footnotes A12065 (11/01)