Blue Shield of Calif — San Francisco

Healthcare

$3.6B

paid by San Francisco, 2013–2027

Departments

What the City pays them for

The City’s own accounting categories, FY2018 on. Hatched bars are money out, but not a purchase.

B Flx Medical-Claims Paidnot a purchase$1.9B B Flx Medical Capitationnot a purchase$740.8M B Flx Claims Paidnot a purchase$668.2M Medical-Health Plan Providersnot a purchase$179.1M Other Professional Services$166.8M

12 categories in all.

In FY2025

$493.0M, in the last year with closed books.

HSS Health Service SystemB Flx Medical-Claims Paid$262.4M HSS Health Service SystemB Flx Claims Paid$98.7M HSS Health Service SystemB Flx Medical Capitation$87.2M HSS Health Service SystemMedical-Health Plan Providers$48.7M HSS Health Service SystemOther Professional Services$20.1M

Paid by year

'13

'14

'15

'16

'17

'18

'19

'20

'21

'22

'23

'24

'25

'26·

'27·

Hatched: FY2026, FY2027 are not closed yet — the bar shows payments recorded so far, not a full year.

Tallest bar — FY2025: $493.0M. Bars are scaled to this payee’s own peak year.

Who pays them

2 departments, 100.0% of it from HSS Health Service System.

HSS Health Service System3,497 vouchers$3.6B DPH Public Health7 vouchers$1,962