Calling it a “financial lifeline” for those who could not easily obtain federal relief funds, Blue Shield of California has said that the $200 million Provider Financial Support Program helped give more than $114 million in direct financial support to 244 healthcare providers during the COVID-19 pandemic. The program was announced last April. Sandra Clarke, chief financial officer and senior vice president for Blue Shield, said the program has been successful in accomplishing “what we intended”.
- Mid-sized practices, hospitals benefited :Sandra Clarke said the initiative has primarily helped small to mid-sized practices and hospitals in their network to rise above the financial turmoil created by the pandemic and meet their cash-flow needs after most elective care was postponed during stay-at-home orders in early 2020.
- Aid requests :She said that many large hospitals and hospital systems were able to tap into federal funding options. The majority of requests for financial support, 89%, came from physicians and other practitioners; 8% came from hospitals or hospital systems; and the remainder was split between independent physicians’ associations (IPAs) and medical groups.
- Advance payments :Blue Shield provided funding to eligible providers as a pre-payment for future services to Blue Shield members. Following a six-month grace period, each provider has the option to repay the funds to Blue Shield directly or to offset the amount owed from new claims for member care over the subsequent 12 months.
- Value-based agreements :Blue Shield assisted providers to deliver value-based, rather than volume-based care. The health plan worked with some commercial providers to convert their existing fee-for-service agreements to value-based contracts that provide a consistent monthly base revenue stream that is less impacted by volatility in patient volume.
- Streamlined member payments :In collaboration with healthcare tech startup OODA Health, Blue Shield enabled providers to receive member payments (such as co-pays) more quickly through automation. Providers have been able to focus on caring for their patients instead of collecting co-pays from Blue Shield members.