DURHAM, N.C. – Blue Cross and Blue Shield of North Carolina (Blue Cross NC) has launched a value-based care program to ensure Blue Cross NC members with kidney disease have access to better, simpler and more affordable health care. The program, which began Jan. 1, is the newest feature in the company’s industry-leading Blue Premier value-based care initiative that pays doctors and hospitals for meeting quality and cost standards.
Blue Cross NC is offering Blue Premier Advanced Kidney Care in collaboration with Fresenius Medical Care North America (FMCNA) and Strive Health, two national leaders in bringing the benefits of better-coordinated, high-quality care to patients with kidney disease. The program is designed to improve health quality and outcomes for members who have advanced kidney disease.
“It’s important that we help our members with chronic conditions receive coordinated care, delay or prevent the need for dialysis, and improve their quality of life,” said Von Nguyen, MD, Blue Cross NC chief medical officer. “Advanced kidney disease has long been challenging to treat. Working with FMCNA and Strive Health, Blue Cross NC is bringing an advanced level of care to help our members who need it most.”
Under the program, Blue Cross NC will collaborate with FMCNA and Strive Health to enroll eligible members at no additional member cost. Members on a commercial or Medicare Advantage plan who have chronic kidney disease stage 4 or 5 or end-stage renal disease may join. FMCNA and Strive Health will work with primary care physicians and nephrologists in the Blue Cross NC network to identify care gaps and support providers in delivering high-quality, coordinated and patient-centered care – for example, scheduling regular preventive care to ensure that patients don’t miss needed medical encounters. Members may keep their current providers. Strive Health is serving 85 counties across the state and FMCNA is in the other 15 counties, in the Charlotte and Wilmington areas.
Benefits of Blue Premier Advanced Kidney Care include:
Comprehensive member care management and disease education
Enhanced care coordination among primary care, nephrology and other specialties
Value-based care payments based on provider accountability for total cost of care and quality performance measures (unlike traditional fee-for-service kidney care in which providers are paid on the basis of how many procedures and tests they perform)
“Kidney disease is complex, and it disproportionately impacts certain patient populations,” said Chris Riopelle, CEO of Strive Health. “Through transformative, value-based kidney care, Strive Health addresses patient care in a way that will help Blue Cross NC improve members’ lives while controlling long-term health care costs. We are excited to bring our Kidney HeroTM teams to North Carolina, where they can deliver compassionate and complete care that fits with members’ daily lives.”
“We are pleased to have been chosen by Blue Cross NC to deliver the Blue Premier Advanced Kidney Care program,” said David Pollack, president of Fresenius Health Partners, the value-based care services division of FMCNA. “Our KidneyCare:365 program is designed to deliver outcomes-based care models that better align health plans and provider networks around the total health care experience for each patient. Together with our physician partners in InterWell Health, a network of high-performing nephrologists focused on value-based care, our team will deploy proven care coordination systems and services to improve the lives of patients living with kidney disease.”
Blue Cross NC’s Blue Premier is recognized as one of the most rapid and comprehensive shifts to value-based care in the nation by any health plan. Blue Premier agreements cover multiple years and build toward shared financial risk between Blue Cross NC and providers, which sets the program apart from other value-based care arrangements. When providers and insurers are aligned on their goals, patients see better, simpler and more affordable health care.
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.
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 Fresenius Medical Care North America
Fresenius Medical Care North America (FMCNA) is the premier healthcare company focused on providing the highest quality care to people with renal and other chronic conditions. Through its industry-leading network of dialysis facilities and outpatient cardiac and vascular labs, Fresenius Medical Care North America provides coordinated healthcare services at pivotal care points for hundreds of thousands of chronically ill customers throughout the continent. As the world’s largest fully integrated renal company, it offers specialty pharmacy and laboratory services, and manufactures and distributes the most comprehensive line of dialysis equipment, disposable products, and renal pharmaceuticals. For more information, visit https://fmcna.com/.
About Strive Health
Strive Health is the national leader in value-based kidney care and partner of choice for innovative healthcare payors and providers. Strive Health's model uses a unique combination of high-touch care teams, predictive analytics, advanced technology, seamless integration with local providers, and next-generation dialysis services to form an integrated care delivery system that supports the entire patient journey from chronic kidney disease (CKD) to end stage renal disease (ESRD). Strive Health partners with commercial and Medicare Advantage payors, Medicare, health systems, and physicians through flexible value-based payment arrangements, including risk-based programs. Backed by New Enterprise Associates, Town Hall Ventures, Echo Health Ventures, and Ascension Ventures, Strive Health delivers compassionate kidney care the way it should be done. For more information, visit us on Twitter, LinkedIn or at www.strivehealth.com, or email info@strivehealth.com.