Durham, N.C. – Blue Cross and Blue Shield of North Carolina (Blue Cross NC) and UNC Health Care announced today that Blue Cross NC will be reducing Affordable Care Act (ACA) rates for individual customers in the Triangle by an average of 4.5 percent—or an average reduction of more than 25 percent over the past two years. The reduction builds on the agreement launched last year that made UNC Health Care’s Clinically Integrated Network, UNC Health Alliance, Blue Cross NC’s in-network provider for its greater Triangle region individual ACA plans.
Statewide, Blue Cross NC is lowering rates by an average of -5.5 percent for individuals. All 100 counties will see an average rate decrease for the first time in the history of Blue Cross NC since entering the current individual market more than 25 years ago.
“For the second year in a row, our agreement with UNC Health Care is lowering costs for our customers,” said Patrick Conway, President and CEO of Blue Cross NC. “We have a lot of work left to do, but this shows what’s possible when both the insurer and the provider are jointly responsible for better, simpler, more affordable care. We’re going to keep building on these successes, and become a national model for what high-quality, more affordable, consumer-focused health care looks like.”
UNC Health Care CEO Wesley Burks, MD, echoed Conway’s sentiments. “Just one year ago, we announced that UNC Health Care’s Clinically Integrated Network, UNC Health Alliance, had been selected as Blue Cross NC’s in-network provider for individual ACA plans in the greater Triangle,” Burks said. “This additional reduction of Triangle ACA rates is welcomed news for patients and helps enable our long-term goal of improving the health of all North Carolinians,” he continued.
“From world-class facilities such as UNC Medical Center in Chapel Hill and Hillsborough to UNC REX in Raleigh, and in collaboration with the high-quality network of UNC Health Alliance providers across the greater Triangle, Blue Cross NC ACA members are benefiting from the nationally ranked expertise UNC Health Care provides.”
The agreement between UNC Health Care and Blue Cross NC will further reduce rates for Triangle customers by an average of more than $200 a year before subsidies, or an average of nearly $1,900 a year before subsidies for the last two years. Benefits will remain similar.
The agreement means a $20 million in reduction in health care costs in the region for 2020, or a $220 million reduction over the past two years.
Members in the Triangle will now have access to ‘Blue Home with UNC Health Alliance’ for 2020. ‘Blue Value with UNC Health Alliance’ will not be offered in 2020. ‘Blue Home with UNC Health Alliance’ will be available in Wake, Johnston, Franklin, Lee, Chatham, Alamance, Orange, Durham, Caswell and Person Counties.
Blue Cross NC insures 90,000 individual ACA customers in the 10-county region where ‘Blue Home with UNC Health Alliance’ will be offered.
A High-Quality Network
Members will have access to the full UNC Health Alliance network.
The UNC Health Alliance network includes:
- More than 5,000 UNC Health Care and independent providers in 48 counties throughout the state of North Carolina.
- More than 850 primary care providers and 3,300 specialty providers.
- More than 500 locations in the 10-county region that Blue Home will be offered.
- In-network hospitals: UNC Hospitals at Chapel Hill, UNC REX Healthcare in Raleigh, Chatham Hospital, Johnston Health Services, Pardee Memorial Hospital, Caldwell Memorial Hospital, UNC Lenoir Hospital, Nash Hospitals, Wayne Memorial Hospital, and UNC Rockingham Health Care.
More than 85 percent of the primary care and specialist providers who cared for Blue Value Triangle members in 2019 will remain in network for 2020. Some non-UNC Health Alliance providers who were in-network with ‘Blue Value with UNC Health Alliance’ will no longer be in-network with ‘Blue Home with UNC Health Alliance.’ In-network providers include the full UNC Health Alliance network, plus some additional providers, selected by Blue Cross to ensure members have access to the care they need.
Beginning in October, members can use Blue Cross NC’s “Find a Doctor” tool to see if their provider is in-network. Additionally, members can call the number of the back of their insurance card for help finding quality, in-network care.
Additional Factors Impacting Rate Reduction
- Provider Relationships: The strong collaboration between Blue Cross NC and UNC Health Care has reduced rates by more than 25 percent over the past two years.
- The Move to Value: The rate reductions are supported by the company’s industry-leading move to value-based provider reimbursement. Blue Cross NC is also providing more resources and data to independent primary care practices so they can participate in value-based care models.
- Marketplace Expertise: Blue Cross NC has gained substantial insights about its ACA customers over the six years it has participated in the marketplace. This information has allowed the company to better coordinate care for these members and reduce the medical expenses for the care they require.
- Greater Stability and Certainty: Rates have stabilized because of the state legislature’s and regulators’ willingness not to add additional health insurance mandates and regulatory burdens that drive costs up for individuals and small business.
- Internal Savings: Blue Cross NC continues to make progress on reducing internal overhead operating expenses.
Rates vary based on location, age, subsidy amount, and plan. Federal tax credits known as premium subsidies are available for customers with household incomes between 100 and 400 percent of the Federal Poverty Level. About 85 percent of Blue Cross NC current members with individual ACA plans qualify for subsidies this year. Subsidies vary by plan and household income.
Individual premiums will be available in October. Open enrollment begins on November 1, 2019 and ends on December 15, 2019.
About Blue Cross and Blue Shield of North Carolina:
Blue Cross and Blue Shield of North Carolina (Blue Cross NC) improves the health and well-being of our customers and communities by providing innovative health care products, services and information to more than 3.8 million members, including approximately 1.1 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 NC online at bluecrossnc.com. All other marks are the property of their respective owners.
About UNC Health Care
UNC Health Care is an integrated health care system owned by the state of North Carolina and based in Chapel Hill. It exists to further the teaching mission of the University of North Carolina and to provide state-of-the-art patient care.
UNC Health Care is comprised of UNC Medical Center in Chapel Hill, ranked consistently among the best medical centers in the country; the UNC School of Medicine, a nationally eminent research institution; Pardee UNC Health Care in Hendersonville; Chatham Hospital in Siler City; Johnston Health in Clayton and Smithfield; UNC Lenoir Health Care in Kinston; Wayne UNC Health Care in Goldsboro; Caldwell UNC Health Care in Lenoir; Nash UNC Health Care in Rocky Mount; UNC Rockingham Health Care in Eden, Onslow Memorial Hospital in Jacksonville, UNC REX Healthcare and its provider network in Wake County; and the UNC Physicians Network. For more information, please visit www.unchealthcare.org.