BlueCross BlueShield Expands Value-Based Program, Improves Rural Care

BlueCross BlueShield (BCBS) of North Carolina and Caravan Health announced plans to expand Blue Premier, the insurers value-based care program, into more communities throughout the state.

Through the creation of a new accountable care organization (ACO), the two companies are aiming to bring the “benefits of value-based care for patients—including improved quality and better-coordinated care—to North Carolinians who don’t live near a hospital already in Blue Premier.”

Blue Premier is different than other insurers agreements in that is covers multiple years and builds shared financial risk between BCBS and providers. In 2019, providers who participated in the program generated and estimated $153 million in cost savings, quality improvements, and slowed down the rate of health care spend.

“Extending value-based care through Blue Premier is an important next step in supporting community and rural hospitals, especially as the pandemic has exposed the flaws of fee-for-service,” said Von Nguyen, MD, Blue Cross NC chief medical officer in a press release. “Caravan Health will be an essential part of making the benefits of value-based care available to more Blue Cross NC members through access to better, more affordable care.”

In rural areas, where doctors and hospitals play a critical role in improving health, the new ACO will help providers better manage and treat chronic conditions, share in the cost savings through value-based care, and move to a more sustainable financial model than traditional fee-for-service health care—potentially even helping them stay in business following the financial distress caused by COVID-19, stated BCBS in the press release.

 “The opportunity to align efforts across multiple lines of business dramatically reduces the cost of change for providers, and I thank the team at Blue Cross NC for their foresight in how they’ve designed Blue Premier,” said Tim Gronniger, Caravan Health CEO and president, in a press release. —Edan Stanley