Partnership Profile: Blue Cross Blue Shield of North Carolina

Submitted by hci3-usr on Monday, March 30, 2015 - 01:54

We firmly believe there is strength in numbers. Moving the needle forward in reforming our health care system cannot be placed on one person or organization alone. It takes many dedicated individuals and leaders across the nation coming together, bringing their intellect, resources and inspiration to change the status quo.

The Health Care Incentives Improvement Institute (HCI3) is proud to partner with organizations that have this dedication. Blue Cross and Blue Shield of North Carolina (BCBSNC) has been a partner for over a decade and has served the Tar Heel State for more than 80 years, providing high-quality health insurance coverage through access to a premier network of doctors and hospitals in all 100 counties. The mission of the organization is to improve the health and well-being of North Carolinians, a commitment that includes a leadership role in the effort to create a health care system that is accessible, affordable and consumer-focused.

2014 was a busy year for the health care industry. What does BCBSNC consider one of its proudest accomplishments?
BCBSNC devoted considerable energies to health care reform and implementation of the Affordable Care Act in 2014, enrolling 250,000 customers on ACA plans last year. As the only insurance company to serve all 100 counties on the federal Health Insurance Exchange at all metallic levels, we also expanded our efforts to educate consumers on how to shop for coverage and apply for subsidies. Our customer service representatives fielded a record number of phone inquiries, while our seven new retail locations offered face-to-face consultations with North Carolinians exploring their health care options. We also opened a new customer service call center in Fayetteville to better serve our commercial customers, adding 100 jobs to the Fayetteville area.

What is in store for BCBSNC in 2015? What opportunities are you most excited about?
In the coming year and beyond, BCBSNC will focus on the move toward a more value-based health care system, providing consumers with more information about the health care system and increasing the level of cost transparency in health care. In early 2015, BCBSNC sparked a national dialogue with the release of a unique cost transparency tool that provides all consumers with access to the costs of more than 1,200 elective medical procedures. Armed with this kind of information, consumers will be able to make better decisions about their health and their spending on health care.

BCBSNC will also continue to explore new collaborations that are aimed at improving health care quality and controlling costs. We are committed to collaborating and innovating with our health care partners, with initiatives establishing bundled payment agreements that set a fixed price for the entire episode of care for certain medical procedures and Accountable Care Organizations with more personalized, coordinated care and incentives for positive health outcomes.

What current trends in health care do you see as the most significant and what role will your BCBSNC play in moving the trend forward?
The shift toward consumerism will be the most important development in health care this year and it will continue to define our system for years to come. Consumers want better communication tools, access to cost information and greater control over health care decisions affecting them and their families. BCBSNC has taken a leadership role in the transition to consumerism and will continue to respond to the feedback we receive from North Carolinians about the kind of health care system they want. In early 2015, BCBSNC launched a first-of-its-kind cost transparency tool that allows all consumers – not just our customers – to find out the costs of more than 1200 elective medical procedures. Already, the transparency tool has accelerated the national dialogue on the cost of care.

How do you see this trend affecting consumers?
With a deeper understanding of how the health care system operates and the factors that affect health care costs, consumers can better control their own spending on health care. More importantly, providing consumers with information about health care outcomes and provider quality will help consumers seek health care providers who offer better value.

We continue to see health care costs rise and it is putting a strain on our country and consumers. Do you have any programs, initiatives or relationships in progress that aim to address or remedy this issue?
We agree – health care costs have become a major strain on everyone. In 2011, BCBSNC started a public conversation about the issue with our Let’s Talk Cost campaign, providing consumers with data on waste and inefficiency in health care and offering our perspective on how to get the best value from our nation’s health care system.

The Affordable Care Act has helped expand access to health care, but it has done very little to control costs. BCBSNC will continue to broaden its range of tools to help consumers take more control over their health care and what they spend on it: mobile communication tools that allow consumers to communicate with doctors and research health care options; our BlueConnect portal that allows members to monitor their health and insurance costs; and online information about how to live healthier, more active lives.

In addition, we have established a number of collaborations with providers to form Accountable Care Organizations in regions across the state, helping doctors move toward more sustainable health care delivery and payment models that focus on positive health outcomes. We also have very successful bundle payment agreements in which we are obtaining significant savings.

At HCI3, we are very excited to be working with BCBSNC and applaud your efforts. What are your hopes and expectations from the relationship as we work together in 2015?
BCBSNC shares HCI3’s dedication to realizing significant leaps in the quality of health care, which is crucial to controlling costs and is the focal point of our company’s mission to improve the health and well-being of our customers and communities. Higher quality health care will reduce waste and inefficiency in the system, substantially slowing the rise in costs. Together, BCBSNC and HCI3 can continue to develop performance measures for doctors and tie those measures to incentives. 

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