In addition to wellness programs, his group has been championing something he said everyone in health care doesn't necessarily like: cost transparency.

In a slide during his talk, Bodaken noted that a heart bypass in Marysville, a town north of Sacremento, costs roughly five times the state average.


"This is the function of a system that is not based on value, but a system that has been based on how much can I negotiate for my piecework," he said.

One response has been legislative. Bodaken said his group backed SB 751, signed into law earlier this year by California Gov. Jerry Brown, which he said lets health plans share hospital cost and quality information with members, and forbids hospitals from inserting gag clauses in contracts with plans.

More directly, he said Blue Shield is trying to be transparent about profits, of which income is capped at two cents per dollar of revenue. Excess income is given back to customers or the community. Last year, Blue Shield gave back $180 million. This year, $295 million, he said.

"We think it gives the consumer informed choice," he said. "We think that's the first step."

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