DURHAM, N.C. – Blue Cross and Blue Shield of North Carolina (Blue Cross NC) announced that its industry-leading Blue Premier program saved members $130 million in health costs in 2021, reaching a milestone of nearly half a billion dollars in cost savings, according to an analysis from Blue Cross NC.[i]
Blue Premier modernizes health care by rewarding quality of care, resulting in fewer unplanned hospital admissions and more preventative care, saving lives and making health care more affordable. Hospital and doctor payments are based on successful treatments rather than only the number of procedures or tests performed. This program is helping to create a system where high-quality care is affordable for all.
“The results show Blue Premier is working for our members by improving quality of care, and that’s our number one priority,” said Dr. Stephen Friedhoff, senior vice president of health care services at Blue Cross NC. “When we can help make health care more affordable, accessible, and easier to navigate, we make it better for all.”
Providers participating in Blue Premier met their performance goals by delivering high-quality, cost-effective care for the nearly 1.4 million members they served in 2021.[ii] That’s up from 857,000 members in 2020.[iii] Specific quality improvements through Blue Premier in 2021 include:
- A 5% reduction in unplanned hospital readmissions among adult members seeking care at a Blue Premier facility, compared to 2020[iv]
- A 12% increase in the percentage of members who took steps to manage blood pressure in 2021, compared with 2020[v]
- Approximately 24,000 more colorectal screenings than in 2020, averting up to 570 preventable deaths from colorectal cancer, according to health screening calculations from the U.S. Preventive Services Task Force[vi],[vii]
Under Blue Premier, a value-based care model, providers and Blue Cross NC are more closely aligned on goals to help patients receive better, more affordable, more coordinated care. A growing number of Blue Premier providers are in shared-risk agreements – accountable financially for meeting cost and quality standards – making Blue Premier one of the most advanced value-based care programs in the nation. Providers earned almost $321 million in shared savings by improving quality and reducing costs in the program’s first three years, including over $100 million in 2021.[viii]
These and other quality improvements are included in performance calculations that Blue Cross NC has made in collaboration with Blue Premier providers. In its first three years, Blue Premier has saved nearly $500 million in health care costs, helping Blue Cross NC curtail the impact of medical cost inflation in premiums. This includes the most recent calculation of $130 million for 2021 estimated total impact. It follows $197 million in savings in 2020, and $153 million in 2019, the program’s first year.[ix],[x]
The $130 million in savings in 2021 is broken into two areas – $110.6 million for traditional Blue Premier participants and $19.5 million in savings from the Blue Premier Advanced Kidney Care (AKC) program.[xi] The AKC program is designed to slow or stop the progression of kidney disease.
Blue Premier has grown rapidly since its inception in 2019: Agreements are in place with 12 major hospitals and health systems and almost 800 independent primary care practices across the state.[xii],[xiii] The systems currently in Blue Premier account for nearly 70% of Blue Cross NC’s total medical expense, excluding prescription drugs.[xiv]
Blue Premier is just one of the ways Blue Cross NC is working to make health care more affordable and easier to access. For more information on how Blue Cross NC is taking on the high cost of health care, visit treatthecost.com.
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 4.3 million members, including approximately 1.2 million on behalf of other Blue Plans.[xv] 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.
[i] Internal Blue Cross NC data, 2021 BP Savings By Segment, September 2022
[ii] Internal Blue Cross NC data, Value Platform, December 2021 (Accessed April 2022)
[iii] Based on internal Blue Cross and Blue Shield of North Carolina (Blue Cross NC) data, 2021
[iv] Internal Blue Cross NC data, Hospital Quality BP Story 2021, July 2022 (Accessed September 2022)
[v] Internal Blue Cross NC data, 2021 Blue Premier Quality Story, July 2022 (Accessed September 2022)
[vi] Internal Blue Cross NC data, 2021 Blue Premier Quality Story, July 2022 (Accessed September 2022)
[vii] U.S. Preventive Services Task Force, online: uspreventiveservicestaskforce.org/uspstf/recommendation/colorectal-cancer-screening, May 18, 2021 (Accessed September 2022)
[viii] Internal Blue Cross NC data, 2019-2021 Program Payout, September 2022
[ix] A new decade of Value transformation, Blue Premier Refresh 2022", November 2021
[x] Internal Blue Cross NC data, 2019 BP Savings, August 2020 (Accessed September 2022)
[xi] Internal Blue Cross NC data, 2021 BP Savings By Segment, September 2022
[xii] Internal Blue Cross NC data, Negotiation Status Report, February 26, 2021 (Accessed September 2022)
[xiii] Internal Blue Cross NC data, IPC Blue Premier Practices, April 21, 2022 (Accessed September 2022)
[xiv] Internal Blue Cross NC data, 2021 Value Partner Spend for Blue Premier, September 2022
[xv] Internal Blue Cross NC data, QA 2021 Financials, March 2022 (Accessed September 2022)