Why Blue Shield of California, Included Health put $464M on the line with state contract

Becker's Healthcare June 21, 2024
Rylee Wilson

The California Public Employees’ Retirement System awarded its PPO contract to Blue Shield of California, the first time the contract has changed hands in 20 years.

Blue Shield of California was awarded the contract, which provides coverage to more than 400,000 current and retired California state employees, over Anthem Blue Cross. As part of the agreement, Blue Shield will be responsible for hitting medical cost trend and quality improvement targets.

In the first year, Blue Shield and Included Health, which will provide population health management, must keep costs under 5.5%. The target shrinks to 3% by 2029. Blue Shield and Included Health will stake $464 million in hitting these targets.

Sandra Clarke, COO of Blue Shield of California, sat...

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