DURHAM, N.C. – Blue Cross and Blue Shield of North Carolina (Blue Cross NC) announced that its industry-leading Blue Premier program improved quality of care for patients and saved nearly $164 million in health care costs in 2022, helping curtail the impact of medical cost inflation for members and small and large businesses. The total savings since the program was created in 2019 has reached close to $650 million, according to an analysis from Blue Cross NC.[i] Blue Premier is just one of the ways Blue Cross NC is working to make health care more affordable. In 2022, Blue Cross NC reduced medical expenses by $392 million through a number of targeted cost savings initiatives.
Blue Premier is recognized as one of the most rapid and comprehensive shifts to value-based care in the nation by any health plan. Participating doctors and hospitals and Blue Cross NC are jointly accountable for meeting quality and cost measures. This approach modernizes health care by rewarding quality of care, resulting in fewer unplanned hospital admissions and more preventative care. Payments to hospitals and doctors, including independent providers, are based on improved delivery of care rather than only the number of procedures or tests performed. This program is building a system where high-quality care is affordable for all North Carolinians.
“Blue Premier is not only making health care more affordable and accessible; it’s improving the quality of care for our members,” said Troy Smith, vice president of affordability and value programs at Blue Cross NC. “The year-over-year results show that Blue Premier is a sustainable model of collaboration in the health care system where the member is at the center of it all.”
“Our partnership with Blue Cross NC in Blue Premier aligns directly to UNC Health’s core mission to make health care more affordable and accessible and allow our physicians and hospitals to not only treat patients and families when they get sick, but rather help them to stay healthy,” said Dr. Mark Gwynne, president of UNC Health Alliance, the clinically integrated network and population health services organization at UNC Health. “Since starting this partnership, our UNC Health Alliance network physicians and hospitals have improved outcomes across chronic conditions like diabetes and hypertension while also building new infrastructure to directly care for patients with behavioral health needs. Managing patients and families more holistically also means meeting them where they are by offering virtual care, hospital care at home and many other in-home needs, all of which Blue Premier has helped make happen."
Doctors and hospitals, including independent 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 2022. Specific examples of quality improvements for Blue Premier-participating providers included[ii]:
- An 18% reduction in unplanned hospital readmissions among adult members seeking care at a participating health care system, compared to 2021
- A 15% increase in the percentage of members who took steps to manage blood pressure in 2022, compared with 2021
- Approximately 10,000 more colorectal screenings than in 2021
Blue Premier Participation
A growing number of Blue Premier doctors and hospitals are participating in advanced-risk agreements – accountable financially for meeting cost and quality standards. Providers earned almost $438 million in shared savings by improving quality and reducing costs in the program’s first four years, including over $117 million in 2022[i].
- Blue Cross NC is the only insurer that serves all 100 counties of North Carolina with coverage options for individuals of all ages, and for businesses of all sizes. The Blue Premier program includes doctors and hospitals serving members in all 100 counties, helping provide critical access to primary care.
- Agreements are in place with 12 major hospitals and health systems and more than 800 independent primary care practices across the state.
- The systems and physicians currently in Blue Premier account for nearly 65% of Blue Cross NC’s total medical expense, excluding prescription drug costs.
About 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.[iv] Blue Cross NC 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.