Durham, N.C. – Blue Cross and Blue Shield of North Carolina (Blue Cross NC) and Wake Forest Baptist Health today announced an agreement that could reduce Affordable Care Act (ACA) rates for individual customers by up to 40 percent. The agreement could mean a $60 million reduction in premiums for 2020 in the region.
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.
“When insurers and providers work together, the customer wins,” said Patrick Conway, President and CEO of Blue Cross NC. “We are thrilled to have reached an agreement with Wake Forest Baptist Health that will provide our customers with access to a high-quality, more affordable health plan. While we have a lot of work left to do, we’re going to keep building on successes like these, and become a national model for what better, simpler, more affordable health care looks like.”
Kevin High, M.D., President of Wake Forest Baptist Health System said, “We are pleased to partner with Blue Cross NC to offer a cost savings to the ACA members in our region. We are honored to serve all ACA members through this partnership and committed to providing the same high quality, convenient care across all of the communities we serve.”
The decreases will be available through a new product called Blue LocalSM with Wake Forest Baptist Health.
Members wanting to take advantage of the reduced rates must switch to Blue Local.
Individual switching from a:
- Blue ValueSM plan will save, on average, $1,330 a year before subsidies.
- Blue Advantage® plan will save, on average, $3,400 a year before subsidies.
Blue Cross NC will continue selling Blue Advantage and Blue Value products in the region. However, due to the way the federal government calculates subsidies, members who choose to stay with Blue Advantage or Blue Value will see a subsidy decrease, because of the lower cost Blue Local product.
As always, rates vary based on location, age, subsidy amount, and plan. Federal tax credits known as premium subsidies are still available for customers with household incomes between 100 and 400 percent of the Federal Poverty Level. About 85 percent of Blue Cross NC current customers with individual ACA plans qualify for subsidies this year. Subsidies vary by plan and household income.
Blue Cross NC insures more than 70,000 individual ACA customers in the counties where Blue Local with Wake Forest Baptist Health will be offered. The product will be sold in Stokes, Yadkin, Forsyth, Davie, Davidson, Guilford, Randolph and Wilkes counties.
A High-Quality Network
Blue Local members will have access to a high-quality, coordinated network.
The Blue Local network consists of:
- Wake Forest Baptist Health, an academic medical center which includes:
- Four community hospitals
- Brenner Children’s Hospital
- New leading-edge labor and delivery and high-risk infant care at The Birth Center and Dale & Karen Sisel NICU
- One of only 49 National Cancer Institute-designated comprehensive cancer centers in the country
- More than 300 primary care and specialty clinics
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 on 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 Wake Forest Baptist Health is reducing rates by up to 33 percent for individuals.
- The Move to Value: This new offering takes advantage of Wake Forest Baptist’s expertise and progress in providing value-based care to patients for the past five years. The rate reductions are supported by Blue Cross NC’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 also 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 customers 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.
Individual premiums will be available in October. Rates for the new Blue Local with Wake Forest Baptist Health will be available on November 1.
Open enrollment begins November 1, 2019, and ends 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 Wake Forest Baptist Health:
Wake Forest Baptist Health (www.wakehealth.edu) is a pre-eminent academic medical center based in Winston-Salem, North Carolina. Wake Forest Baptist Health’s two main components are an integrated clinical system – anchored by Wake Forest Baptist Medical Center, an 885-bed tertiary-care hospital in Winston-Salem – that includes Brenner Children’s Hospital, four community hospitals, more than 300 primary and specialty care locations and more than 2,000 physicians; and Wake Forest School of Medicine, a recognized leader in experiential medical education and groundbreaking research that includes Wake Forest Innovations, a commercialization enterprise focused on advancing health care.