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April 22, 2020

Blue Shield of CA offers $200 million in financial support for providers

Program options include advance payments and loan guarantees.
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Blue Shield of California is now accepting applications for $200 million in direct support options to physician practices and other health care providers. For more information and to apply for the programs, email Financecommunication@blueshieldca.com. California providers should apply soon because available funding is limited.

The program includes the following options:

  • Advance payments – Eligible providers can receive a pre-payment for future services. No repayments are required during a six-month grace period, after which repayment amounts will be offset from claims payments, generally in equal installments over twelve months. For HMO providers, repayment amounts will be offset from monthly capitation payments.
  • Loan guarantees – Blue Shield intends to guarantee loans issued by a third-party lender to providers. The loans, not to exceed $2 million (other limits apply) will be available with flexible repayment terms.
  • Assuming member liability obligations through OODA Health – OODA Health is working with Blue Shield to expand its service offering that pays Blue Shield members’ liability to providers more quickly. There will be two components: First, qualifying providers can arrange for OODA to assume responsibility for member out-of-pocket costs on future encounters. Second, providers can transfer certain existing Blue Shield member’s share receivables to OODA for collection. Receivables will be transferred at a negotiated rate upfront, with the potential for additional payments based on actual collection rate and subject to final terms of agreement.
  • Transitioning to value-based agreements – Blue Shield will work with select Commercial providers to convert their existing fee-for-service agreements to a value-based contract (where available) or a risk-sharing capitated contract that provides a monthly base revenue stream. Providers may be eligible to receive prepayments on the monthly revenue and participate in technology-enabled tools and services designed to help make medical practices more efficient and effective.

 

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