A look at year one of Blue Cross NC's Blue Premier value-based care program

Blue Cross and Blue Shield of North Carolina's Blue Premier value-based care program generated $153 million in savings during its first year, new data released by the insurer show.

As a result, Blue Cross NC has made $85 million in performance payments to participating providers, it announced Thursday.

Cone Health, Duke University Health System, UNC Health, Wake Forest Baptist Health, WakeMed Health and Hospitals and primary care practices in Aledade accountable care organizations have all participated in the program since its inception in January 2019.

Since then, Atrium Health, Novant Health and FirstHealth of the Carolinas have also joined the program. Thanks to the program, 52% of Blue Cross NC's members see a provider who's in a value-based care arrangement.

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“The first full year of Blue Premier shows us what’s possible when we change the way we pay for health care,” said Rahul Rajkumar, M.D., Blue Cross NC senior vice president and chief medical officer, in a statement. “These preliminary results show that Blue Premier providers have stepped up to improve care for Blue Cross NC members and help make North Carolina a leader in the movement to value-based care.”

In addition to the financial savings, the program produced notable quality improvements in the first year, Blue Cross NC said. The insurer said 536,000 members saw improvements in care during 2019.

For example, an additional 3,041 members were screened for colorectal cancer, and 13,412 more had controlled blood pressure than in 2018, Blue Cross NC said, likely avoiding strokes, heart attacks and deaths.

“Blue Premier health systems and physician practices are leading the way to higher quality, more affordable health care in North Carolina and setting the pace nationally,” said Tunde Sotunde, M.D., Blue Cross NC President and CEO, in a statement.