DURHAM, N.C. – The Blue Premier value-based care program from Blue Cross and Blue Shield of North Carolina (Blue Cross NC) created an estimated $197 million in cost savings and quality improvements in 2020, according to an analysis from Blue Cross NC. Despite the pandemic, the impact of Blue Premier grew last year as providers made gains in quality and cost measures and as additional health systems and physician practices joined one of the nation’s leading value-based care efforts.
Collectively, Blue Premier systems and practices met their performance goals for delivering high-quality, cost-effective care for the 857,000 Blue Cross NC members they served last year. The number of members receiving care from a Blue Premier provider increased 60% from the 536,000 served in 2019, the program’s first year.
“These results show Blue Cross NC members are benefitting from our move to value-based care,” said Von Nguyen, MD, Blue Cross NC senior vice president and chief medical officer. “Our close collaborations with hospitals and physicians through Blue Premier have resulted in measurable improvement in health care for our members despite the COVID-19 pandemic.”
Specific quality improvements through Blue Premier last year include:
• A 15% reduction in unplanned hospital readmissions among adult members seeking care at a Blue Premier facility, compared to 2019
• An increase in the percentage of members who had their blood pressure regularly monitored and controlled (53% in 2020, compared with 51% in 2019)
• Almost 10,000 more colorectal screenings than in the previous year, possibly averting an additional 200 deaths from colorectal cancer, according to health screening calculations from the U.S. Preventive Services Task Force
These and other quality improvements are included in performance calculations for 2020 that Blue Cross NC has made in collaboration with Blue Premier providers. The $197 million estimated total impact includes cost savings, quality improvements and a slowdown in the rate of spending on health care. It follows $153 million in savings in 2019, giving the program a $350 million impact in just its first two years.
Under value-based care, providers and insurers are aligned on goals to help patients receive better, more affordable, more coordinated care. Blue Premier takes these goals a step further by building toward shared financial risk. These shared-risk agreements reward providers for better quality and greater cost savings but introduce penalties when goals are not met. Many Blue Premier providers will begin phasing in shared risk next year.
Blue Premier has grown rapidly since its inception: Agreements are in place with 11 hospitals and health systems and more than 870 independent primary care practices across the state, up from five systems in 2019. The systems currently in Blue Premier account for about 65% of Blue Cross NC’s total medical expense.
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 4.2 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.