DURHAM, N.C. and KANSAS CITY, Mo. – Blue Cross and Blue Shield of North Carolina (Blue Cross NC) and Caravan Health are working together to support the expansion of Blue Premier, Blue Cross NC’s value-based care program, to more areas of the state. The two companies will establish a new accountable care organization (ACO) that will work with community and rural hospitals to bring the benefits of value-based care to their communities.
The ACO will enable more North Carolina health systems to collaborate with Blue Cross NC and Caravan to provide high-quality, cost-effective care as part of Blue Premier. Under Blue Premier, participating providers and Blue Cross NC are jointly accountable for meeting quality and cost measures. The ACO will 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.
Hospitals and doctors in rural areas already play a significant role in improving health and coordinating care for their patients. 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.
“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 effective Nov. 1, 2020. “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.”
“We’re excited to team up with community health systems in North Carolina to provide robust primary care and comprehensive accountability for their patients,” said Tim Gronniger, Caravan Health CEO and president. “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. Our team is digging in and looking forward to working side-by-side with providers in North Carolina.”
Improving Rural Health
Community and rural providers have seen challenges in adopting value-based care. The smaller population and gaps in technology can make it difficult to achieve the scale needed to show quality improvements and cost reductions. In North Carolina, with an estimated 28 percent of the state’s population living in areas deemed rural by the U.S. Census Bureau, many residents face shortages of medical providers in their communities. About 26 percent of the providers in Blue Cross NC’s network are in rural areas.
The ACO from Blue Cross NC and Caravan will help address these challenges. Providers will have access to Caravan’s methodologies and resources to help them measure and improve quality. These resources include enhanced data analytics, patient engagement technologies and accountability tools, and on-the-ground support from a regional team.
How Blue Premier Works
Blue Premier is one of the most rapid and comprehensive shifts to value-based care in the nation by any health plan. Under value-based care, provider pay is based on quality of care, not on the quantity of procedures, tests and appointments performed.
Blue Premier agreements cover multiple years and build toward shared financial risk between Blue Cross NC and providers, which sets Blue Premier apart from other value-based care arrangements. Eight of North Carolina’s largest health systems, plus more than 200 independent primary care practices, already are in Blue Premier, and future expansion will take value-based care to more areas of the state. Providers in Blue Premier collaborated with Blue Cross NC to generate an estimated $153 million in cost savings, quality improvements and a slowdown in the rate of spending on health care in 2019, the program’s first year.
How Caravan Health Works
In 2018, Caravan Health pioneered its collaborative ACO model to help providers earn strong, predictable results in the Medicare Shared Savings Program. Larger size is critical to create the scale needed for ACO success. The new health system participants will join a Caravan family of more than 250 health systems, 26,000 clinicians, and over 585,000 attributed Medicare lives. Caravan ACOs lead the nation each year, returning more than $108 million in total shared savings to providers and saving Medicare more than $191 million since 2015 while delivering high scores for quality.
In North Carolina, providers in the Blue Premier ACO will mitigate their risk through Caravan’s risk-sharing solution, which focuses on practice transformation and achieving quality goals.
The Caravan Health and Blue Cross NC teams plan to launch the ACO in January 2021. North Carolina hospitals interested in participating may contact a Caravan Health representative to learn more at caravanhealth.com/contact.
About Blue Cross and Blue Shield of North Carolina
Blue Cross and Blue Shield of North Carolina (Blue Cross NC) is committed to making health care better, simpler, and more affordable. We have been driving better health in North Carolina since 1933, working to tackle our communities’ greatest health challenges. Blue Cross NC serves its customers and communities of more than 3.8 million members, including approximately 1.1 million on behalf of other Blue Plans. Visit Blue Cross NC online at www.bluecrossnc.com.
About Caravan Health
Caravan Health helps providers make accountable care work regardless of their size, location, history, or demographics. Caravan gives community health systems and providers a way to create more scale, drive more change, and generate more revenue. The 250+ health systems who have turned to Caravan achieved single-year savings greatly exceeding the national average. Health systems and providers across the country are using our proven population health programs to ensure better outcomes for their patients every day. With Caravan Health, now the numbers work. For more information visit www.caravanhealth.com.