DURHAM, N.C. – Blue Cross and Blue Shield of North Carolina (Blue Cross NC) has enrolled its first members in Healthy Blue, its Medicaid managed care plan, and has developed a provider network with more than 48,000 physicians and other practitioners, including most of the state’s hospitals and health systems. The start of Healthy Blue enrollment is part of a significant milestone for North Carolina as the state’s Medicaid program transitions to managed care. 

Blue Cross NC is one of five prepaid health plans that started enrolling members on March 15. Medicaid members will begin to receive health care services under the state’s Medicaid transformation program on July 1, 2021. The changes are designed to create a system of better-coordinated, high-quality care for Medicaid beneficiaries, while also offering additional community resources and bringing Medicaid budget predictability to the state.

“Medicaid transformation gives more than 1.6 million North Carolinians the ability to choose a health plan, but it’s more than that. It increases resources to address drivers of health, such as food security and transportation, that impact health outcomes,” said Fran Gary, senior vice president of Government Markets at Blue Cross NC. “Blue Cross NC has designed Healthy Blue to help our Medicaid members get access to the health services and community resources they need to improve their health.”

How Medicaid Managed Care Works

The shift to Medicaid managed care will improve the way health care services are paid for in North Carolina and bring greater value to patients, providers, and taxpayers.

Medicaid traditionally has paid doctors, hospitals and other providers on a fee-for-service basis – meaning the provider gets paid for each procedure, test or patient visit. Under managed care, the state pays prepaid health plans a set amount every month to manage the care of each member. This encourages preventive health, care coordination and meeting a full range of physical and behavioral health needs of members. These types of value-based care approaches reward better health outcomes.

In 2015, the General Assembly approved Medicaid transformation, and now more than 40 states have transitioned their Medicaid program to managed care. Medicaid-eligible North Carolinians may choose a health plan by May 14 or be assigned one beginning May 15. Coverage under each plan begins July 1. 

Healthy Blue Features

In addition to required benefits, plans may also offer value-added services that help members improve their health and well-being. Blue Cross NC offers additional services to Healthy Blue members in all 100 counties to help them get the most out of their plan. These and other features of Healthy Blue include:

Value-added services: Members are eligible for rides to medical appointments, up to $75 in annual rewards for visiting a doctor, $50 to use in an online catalogue for school supplies, and up to $200 to use to for asthma relief products for qualifying members with asthma. Qualifying members are also eligible for three months of fresh vegetables and fruits (up to $120 value).

Provider network: More than 48,000 providers are in the Healthy Blue network, including doctors, hospitals, group practices, behavioral health specialists, federally qualified health centers, rural health clinics, and local health departments. The network creates a coordinated system of care that addresses members’ whole health needs.

Community investments: Strengthening Blue Cross NC’s commitment to addressing non-medical drivers of health, the company is making investments in nonprofits that support improved health at the community level. These include the American Heart Association’s mobile kitchen, El Centro Hispano’s mobile health unit, and the North Carolina Coalition to End Homelessness.

North Carolinians eligible for Medicaid may select a primary care physician, search for other providers or find more information at HealthyBlueNC.com

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 (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. Blue Cross NC is an independent licensee of the Blue Cross and Blue Shield Association. Visit Blue Cross NC online at www.bluecrossnc.com. All other marks are the property of their respective owners.