RALEIGH, N.C. – Three years into their accountable care organization (ACO) collaboration to enhance health care quality and value, WakeMed Key Community Care (WKCC) and Blue Cross and Blue Shield of North Carolina (Blue Cross NC) have achieved measurable improvements in the coordination of care and overall cost, resulting in the reduction of unnecessary costs by nearly $20 million.

The collaboration continues to deliver improved care coordination and greater value to Blue Cross NC customers who receive care from WakeMed Health & Hospitals, WakeMed Physician Practices and Key Physicians, therefore enhancing the overall patient experience. WKCC is an ACO formed in late 2013 to enhance the quality and coordination of health care and reduce the cost of care. WKCC and Blue Cross NC announced their collaboration in July 2014.

As a result of the success so far and the strong collaboration, the two organizations have signed a letter of intent for a multiyear agreement to continue the relationship.

“WakeMed Key Community Care and Blue Cross NC have collaborated for three years in this new model of care, and now we know that it’s working,” said Leslie McKinney, MD, Blue Cross NC lead medical director. “As we continue to strengthen our collaboration with WKCC, we’re actively looking to expand and build on this success – and partner with other providers – as a way to improve health care in North Carolina.”

Brian Klausner, MD, WKCC’s medical director, said the organization’s team approach to care helps improve quality and reduce costs. “We focus on health and well-being of our patients and the community. By aligning our resources, sharing information, streamlining processes and focusing on prevention, quality and controlling medical costs, we are efficiently working together to improve health and health care.”

The two organizations collaborated to set goals for improving care coordination and quality. The goals were based on nationally recognized guidelines and measures for quality patient care. Over the past three years, WKCC has met or exceeded the great majority of those measures. Examples include:

  • Certain cancer screening rates improved;
  • Medication adherence for adult and pediatric patients exceeded measure standards; and
  • Hospital readmissions (within 30 days of discharge from a hospital stay) decreased.

These positive outcomes show the power of collaboration between a health plan and a high quality delivery system where care coordination is a big focus, and patients reap the benefits of better- coordinated, more cost-effective care.

As an example of care coordination, WKCC and Blue Cross NC work together to ensure smooth transitions from the hospital to the home. Using collaborative workflows, WKCC nurse care advisors and Blue Cross NC onsite nurses meet regularly to review individual patient needs, and work with patients and their providers directly to identify appropriate care programs and resources available to them. This coordination helps facilitate the most coordinated care upon their discharge from the hospital and helps avoid unnecessary readmissions.


About WakeMed Key Community Care

WakeMed Key Community Care is an Accountable Care Organization (ACO) established to enhance the quality and coordination of health care, and reduce the costs of care by providing more value for beneficiaries. ACOs enable medical providers to work closer together to create healthier communities and help Triangle-area patients coordinate their health more effectively. A collaboration between WakeMed Health & Hospitals and Key Physicians, WakeMed Key Community Care brings together a network of more than 370 primary care providers with a leading health system and an additional 750 specialty care providers. The partnership is designed to ensure that patients, especially the chronically ill, get the right care at the right time at the right level, while avoiding unnecessary duplication of services and preventing medical errors. It is a limited liability company in which WakeMed Health & Hospitals and Key Physicians are members. For more information, visit www.wakemedkeycc.org.

About Blue Cross NC

Blue Cross and Blue Shield of North Carolina improves the health and well-being of our customers and communities by providing innovative health care products, services and information to more than 3.89 million members, including approximately 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. We have been recognized as one of the World’s Most Ethical Companies by Ethisphere Institute multiple times since 2012. 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 bcbsnc.com. All other marks are the property of their respective owners.