Blue Cross NC Launches Primary Care Initiative for High Quality, Coordinated Patient Care

Insurer collaborates with new providers to make North Carolina a leading state for primary care

DURHAM, NC – Blue Cross and Blue Shield of North Carolina (Blue Cross NC), recognizing the need for always improving how patient care is delivered, has launched a program to expand the services, care and quality of primary care in North Carolina.


Blue Cross NC has entered into agreements with multiple national leaders in delivering intensive primary care. These companies will open new medical practices intended to serve Blue Cross NC members who could benefit the most from highly coordinated, patient-centered care.


“Intensive primary care is better care. When patients with multiple health issues have access to intensive primary care, we know they’re more satisfied, and we know it improves their overall quality of care and reduces total cost of care,” said Rahul Rajkumar, MD, chief medical officer of Blue Cross NC. “North Carolina is already a leading state in delivering innovative approaches to health care challenges, and bringing best-in-class advanced primary care clinics will only enhance the great progress by health care systems and physician practices in making value-based care a reality in North Carolina.”


Intensive primary care provides a high focus on improving the patient experience and the quality of care. These practices will feature team-based care, a dramatically lower number of patients for each physician, and care that addresses the social determinants of health. They will operate under value-based arrangements that change the payment structure and demand better outcomes.


Through these value-based arrangements, insurers pay providers up-front fixed fees to offer a wide range of valuable services to patients. In turn, the providers are held financially accountable for patient outcomes and total health care costs.


“Blue Cross NC is committed to value-based payment arrangements with all primary care physicians and clinicians and health systems presently in North Carolina,” said Patrick Conway, MD, President and CEO of Blue Cross NC. “Increased supply and access to intensive primary care are essential to better patient care, especially as we move to serve the Medicaid population, more Medicare Advantage customers, and an increasingly complex commercial population.”


Blue Cross NC is taking many steps to transform the health care system for high-quality care at lower costs and a better experience. In addition to advanced primary care, Blue Cross NC’s recent announcement of Blue Premier agreements with five leading health care systems across the state is an example of the company’s efforts to transform and improve the health system.


Eligible Blue Cross NC customers engaged in care with these intensive primary care providers will notice:
·    More time during appointments to go over health goals, coaching and resources
·    Support from an entire care team, including behavioral health specialists, health coaches and nutritionists
·    Integration of services such as behavioral health, telehealth, transportation, home visits and palliative care with primary care 
·    Deeper, longer-term relationships with primary care providers
·    Support for finding the highest-quality specialist providers when specialty care is required

 

Blue Cross NC will collaborate with:
·    CareMore Health, a California-based company founded in 1993 that serves high-risk, chronically ill patients. CareMore is a subsidiary of Anthem, Inc. and plans to serve Blue Cross NC Medicare Advantage as well as future Medicaid customers.
·    Cityblock Health, a technology-driven provider that unites primary care, behavioral health, and services to address the social determinants of health to better deliver care to lower-income communities. Cityblock will serve Blue Cross NC Medicare Advantage as well as future Medicaid customers.
·    Iora Primary Care, a Boston-based company that delivers high-impact, relationship-based care to its patients. Iora will serve Blue Cross NC Medicare Advantage customers as well as those on other Medicare plans.

 

In 2019, these providers will establish new medical practices in various regions throughout North Carolina. They will begin accepting Blue Cross NC Medicare Advantage customers in 2020.


“The transformation of health care requires the right delivery models, but it also requires courage, leadership and partnership,” said Sachin H. Jain, MD, MBA, President and CEO of CareMore. “CareMore is proud to collaborate with Blue Cross NC to improve care for the state’s most complex, frail and vulnerable Medicare and Medicaid patients.” 


“We started Cityblock with a simple goal: to radically improve the health of communities, one block at a time,” said Iyah Romm, Cityblock CEO and co-founder. “A fundamental premise of our model is that health is local – so we’re excited for this opportunity to bring better care to neighborhoods where it’s needed most across North Carolina. We will start by first understanding every member’s story, and building trusted relationships across the communities we enter, and only then can we work together towards improved health and well-being. Through our collaboration with Blue Cross NC, we will deploy novel health services and digital tools to reach people with significant health and social challenges across the state and deliver personalized care for every member.”


“We are thrilled to be entering North Carolina this fall and collaborating with Blue Cross NC,” said Rushika Fernandopulle, MD, MPP, co-founder and CEO of Iora. “We look forward to providing Medicare eligibles with care that lowers costs while also improving outcomes. We know that when you invest in relationships and support patients beyond the traditional expectations of primary care, people stay healthier and lead happier lives. In fact, we’ve seen how our more personalized care has helped patients across the country. Now we are proud to be delivering the same great care to North Carolina communities.”


Any reference in this press release to any person, organization, activity, or services related to North Carolina Medicaid does not constitute or imply the endorsement, recommendation, or favoring by North Carolina Department of Health and Human Services.

 

About Blue Cross and Blue Shield of North Carolina
Blue Cross and Blue Shield of North Carolina improves the health and well-being of our customers and communities through innovative health care products, insurance, services and information to more than 3.7 million members, including approximately 1 million served on behalf of other Blue Plans. Since 1933, we have worked to make North Carolina a better place to live through our support of community organizations, programs and events that promote good health. Blue Cross and Blue Shield of North Carolina is an independent licensee of the Blue Cross and Blue Shield Association. Visit Blue Cross online at bluecrossnc.com. All other marks are the property of their respective owners.

About CareMore Health
CareMore Health is a physician-founded, physician-led integrated care delivery system that harnesses the power of teamwork to treat the whole person. Through a focus on prevention and highly coordinated care, its clinical model and designed-for-purpose approach to managing chronic disease proactively addresses the medical, social and personal health needs of its patients, resulting in clinical outcomes above the national average and ultimately, healthier people and communities. Over the past ten years, CareMore has expanded from one state to ten. And today, the CareMore delivery system provides care for enrollees in Medicare Advantage and Medicaid health plans in Arizona, California, Connecticut, Georgia, Iowa, Nevada, Tennessee, Texas, Virginia, and Washington, DC. To learn more about CareMore, go to www.caremore.com and follow us on Twitter, Facebook and LinkedIn @caremorehealth. 

About Cityblock Health
Cityblock Health was founded in 2017 on the premise that health is local. By uniting primary care, behavioral health, and social services to address the root influencers of health with custom-built technology, Cityblock aims to deliver better care for healthier neighborhoods – especially those that have historically had poor access to health care services. In order to provide personalized care for every member, Cityblock partners with community-based organizations, health plans, and other risk-bearing providers to design and deploy a differentiated member experience. To learn more, visit cityblock.com. 

About Iora Primary Care
Iora Primary Care is a doctor’s office dedicated to – and designed especially for – older adults. Our doctors have smaller panel sizes and are able to spend more time with patients in order to understand their health needs and goals. We take a team approach to primary care by working with our patients and their specialists, insurance plan, and caregivers, if needed, to ensure all of their healthcare is on the same page. Find out more by visiting https://ioraprimarycare.com/.