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Blue Shield of California today announced its new "Neighborhood Health Dashboard," an online tool that will advance public health services, and increase transparency around community health and help address health disparities in California.

The Neighborhood Health Dashboard uses data intelligence from dozens of sources to create a comprehensive picture of a community's health including: health outcomes, preventative health care, utilization and access, health behaviors, social risk factors, and environment and economic health conditions.

The innovative onli...

The California Public Employees’ Retirement System on Tuesday approved an increase in health care costs for state and local government employees as the economic slowdown caused by the coronavirus pandemic batters tax collections.

Depending on the plan, the increased health maintenance organization premiums for state workers from the previous year will range from 1.62% to 9.37%, or an average of 4.44%. For participating public agencies and schools, the HMO increase ranges from 0.82% to 11.96% depending on the region and plan.

The preferred provider organizat...

Blue Shield of California has launched a pilot initiative in four counties across the state. 

Under the umbrella of Health Reimagined the pilot programs include adding technology in physician offices, offering digital apps to consumers and tying physician and hospital pay to quality and patient satisfaction.

The efforts range from a customized virtual-care system so patients can see their doctor via smartphone, tablet or computer, to an Apple Watch-enabled virtual assistant that helps physicians create an electronic medical record with their voice, and settling all c...

The program, called “Health Reimagined,” ranges from expanded telehealth connections in rural Butte County to building out primary care in Monterey. New “community health advocates” in Los Angeles and elsewhere will help members with nonmedical needs, like housing and food assistance.

“We came to the conclusion that we couldn’t just incrementally improve on a system that’s fundamentally dysfunctional,” said Paul Markovich, chief executive officer of Blue Shield of California.

Even before the coronavirus pandemic began, physicians suffered from high rates of burnout a...

Imagine a health-care system in which doctors and nurses are so exhausted and beaten down that many of them work like zombies — error-prone, apathetic toward patients and at times trying to blunt their own pain with alcohol or even suicide attempts.

That is what America’s broken health care system is doing to its health workers, according to a 312-page report released Wednesday by the National Academy of Medicine, one of the country’s most prestigious medical institutions.

The report found that as many as half of the country’s doctors and nurses experience substantia...

A federal jury decided Tuesday that insurer Blue Shield of California underpaid a California hospital system for emergency medical services provided to Blue Shield's members.

The jury in the U.S. District Court in San Francisco determined that Blue Shield must pay out-of-network NorthBay Healthcare Group 67% of its billed charges since the end of 2016. King & Spalding, the law firm representing NorthBay, estimated that it would recover more than $16 million, but the exact amount has not yet been decided.

In a statement, however, Blue Shield said the case went to tria...

Fairfield, Calif.-based NorthBay Healthcare may recover $16 million-plus from Blue Shield of California after a federal jury in San Francisco found the health insurer underpaid the hospital system for emergency care.

On Feb. 13, after a six-day trial, the jury found Blue Shield owed NorthBay 67 percent of its billed charges, according to law firm King & Spalding, which represented NorthBay. The exact amount of damages has yet to be determined, but is currently estimated at more than $16 million.

The case stems from December 2016, when Blue Shield and NorthBay ended...

Blue Shield of California is unfairly targeting hundreds of thousands of Covered California enrollees with a coverage change that would prevent them from getting routine care when they are working outside of California, one enrollee told The Sacramento Bee.

Philip Martin has been trying to get Blue Shield to reverse its decision to limit out-of-state medical coverage for PPO members whose policies didn’t go into effect before Jan. 1, 2014, the date when coverage under the Affordable Care Act went into effect. Blue Shield is limiting out-of-state coverage to urgent c...

CentraState Medical Center in Freehold Thursday became the latest hospital to drop a three-year-old lawsuit against Horizon Blue Cross Blue Shield of New Jersey that accused the state's dominant health insurance provider of squeezing community hospitals out of the market.

CentraState was once one of seven hospitals that sued Horizon for relegating them to a more expensive tier in the company's OMNIA discount health plans, which Horizon said would revolutionize health care options in the state.

Valley Hospital in Ridgewood, the last plaintiff in the case, an...

Ashley Summers said she got an unpleasant surprise in February when she tried to pick up a prescription for her rheumatoid arthritis: Her pharmacy said her insurance had been canceled, even though her premiums were paid.

Summers called Blue Shield of California and got her policy reinstated — then she said it happened again in March and this time, the lapse in coverage dragged on for three months.

Without insurance to cover her medications and doctor visits, her arthritis and fibromyalgia worsened to the point that she could barely walk, she said. In June, she said,...

A federal judge in Newark has granted final approval to a $160 million settlement on behalf of out-of-network ambulatory surgical centers which claimed the insurance company’s policies did not provide adequate reimbursement for services rendered.

U.S. District Judge Kevin McNulty approved the settlement terms and granted $9 million in legal fees on Friday, ending a 12-year litigation saga over claims that New Jersey’s largest health insurer shortchanged ambulatory surgical centers outside its provider network.

The suit that just settled, Edwards v. Horizon Blue Cross...

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