DURHAM, NC and BETHESDA, MD – Blue Cross and Blue Shield of North Carolina (Blue Cross NC) and Aledade are launching a new initiative to support hundreds of independently owned and operated primary care physician clinics across North Carolina. The two companies will support physician-led Accountable Care Organizations (ACOs) tailored specifically for primary care physicians and the communities they serve. This care model enables doctors and providers to work as a team to improve the quality of care for their patients, better manage chronic diseases, and ultimately reduce health care costs.
Blue Cross NC and Aledade will work together to provide more resources and encourage data sharing with practices in order to better manage care while improving patient health outcomes. Physicians joining these ACOs can also earn enhanced reimbursement rates and share in a portion of health care cost savings generated from improved quality of care. The joint effort demonstrates Blue Cross NC’s and Aledade’s commitment to creating opportunities for primary care practices to remain financially independent.
“With health care becoming unaffordable for too many North Carolinians, we must change the way we pay for care to focus on paying for healthier outcomes, not simply for the volume of tests and procedures. Primary care physicians influence a vast majority of health care spending, and their role in this transformation is critical,” said Dr. Patrick Conway, CEO of Blue Cross NC. “We want to provide primary care physicians across North Carolina the tools they need to be best-in-class and succeed in a remodeled health care system built on the foundation of value-based, patient-centered care.”
Through these ACO arrangements, Blue Cross NC will collaborate with Aledade to provide physicians with easy-to-use technology and data analytics tools that help make positive changes to a patient’s health care experience. After joining these ACOs, practices gain a more comprehensive view of their patients’ total cost of care, gaps in quality of care, and experiences throughout the entire health care system. For example, physicians will receive notice when their patients visit the hospital or emergency room so they can work with the patient to better manage ongoing health issues. Across the nation, Aledade ACOs have proven to improve access to primary care and reduce preventable hospital stays, emergency room visits, and unnecessary services for Medicare beneficiaries as well as commercially insured members.
“We are proud to work with Blue Cross NC to help improve the quality of care and health of their members, while reining in costs. This is a powerful vote of confidence in our physician-led model that is proven to help primary care practices successfully transition to value-based care,” said Dr. Farzad Mostashari, CEO and co-founder of Aledade. “Through commercial payer arrangements like this, we’re empowering independent physicians to deliver the benefits of value-based care to all of their patients.”
With necessary claims data and support from Blue Cross NC, Aledade will provide participating physicians with a full range of capabilities that include cutting-edge data analytics, user-friendly care management and patient outreach tools, regulatory expertise, and hands-on support from local experts in practice transformation.
The Aledade and Blue Cross NC ACO model is designed to become the preferred value-based care arrangement for independent primary care providers who care for Blue Cross NC’s commercially insured and Medicare Advantage members. Primary care practices under a specialty of internal medicine, family medicine, or general practice for adult care will be eligible to join the ACO model in 2019.
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 3.8 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.
Founded in 2014, Aledade partners with independent practices, health centers, and clinics to build and lead Accountable Care Organizations (ACOs) anchored in primary care. Through these ACOs, Aledade empowers physicians to stay independent, practice medicine like they’ve always wanted to, and thrive financially by keeping people healthy. Aledade offers a comprehensive range of capabilities that include cutting-edge data analytics, user-friendly guided workflows, unparalleled regulatory expertise, strong payer relationships, and local, hands-on support from attentive experts. In true alignment with its partners, Aledade shares in the risk and reward across over 30 value-based governmental and commercial contracts covering more than 300,000 lives in 18 states. To learn more, visit www.aledade.com or follow on Twitter or Facebook.