Blue Shield of California explores the strategic and operational challenges faced by the not-for-profit health insurer as it navigates a rapidly changing healthcare landscape. Rising costs, federal policy shifts, and advances in technology force CEO Paul Markovich to rethink the organization’s role. The case highlights strategic dilemmas such as scaling innovations like Accountable Care Organizations (ACOs) and artificial intelligence while balancing immediate business priorities and long-term transformation goals. Students are encouraged to consider how an organization like Blue Shield can drive systemic change in the U.S. healthcare system.
