BCBS NC inks value-based deal with UNC Health, driving down ACA premiums

Pushpin showing North Carolina on a map
BCBS NC's new value-based agreement with UNC Health will lead to a 21% drop in ACA premiums for some customers. (Getty/Creative RF)

Blue Cross Blue Shield of North Carolina’s new deal with UNC Health Alliance will bring exchange premiums down 21% in one area of the state, the insurer announced this week.

However, outside of the state’s Triangle region, which includes Raleigh, Durham and Chapel Hill, beneficiaries will see a less than 10% bump in premiums. At the same time, the insurer is also cutting ties with two other large systems—WakeMed and Duke Health—by discontinuing its Blue Local exchange offering by the end of the year.

That change will leave approximately 50,000 members looking for new plans next year. To fill that gap, Duke and WakeMed have reached an agreement with Centene subsidiary Ambetter of North Carolina to provide coverage for 40,000 members and remain with their provider.

WakeMed and Duke will remain in-network for other BCBS Plans.

BCBS NC announced the changes after its Affordable Care Act rates were approved by the state on Wednesday. Average premiums on ACA plans will drop 4.1% thanks, in large part, to the deal with UNC Health, BCBS spokesman Austin Vevurka told FierceHealthcare.

“The main factor was new provider agreements that lower healthcare costs,” he said.

The new Blue Value plans, with UNC Health as the exclusive provider, will save members in the Triangle nearly $1,700 a year before subsidies. The deal also represents a distinct push toward value-based care.

Vevurka said BCBS selected UNC based on its low costs and high quality of care. BCBS insures 90,000 people in the 10 counties where Blue Value will be offered. 

“Our agreement with UNC Health Alliance allows us to offer similar plans, but at a significantly lower cost,” Patrick Conway, president and CEO of Blue Cross NC, said in a statement. “What makes this possible is that UNC agreed to partner with us on an arrangement where we’re both responsible for the quality and total cost of care."

"We will work with our current Blue Local customers to find in-network providers, and make sure they are getting the care they need throughout this transition," he added.

RELATED: Trump administration policies could account for $1,000 average increase in ACA premiums

Around the country, ACA premiums have varied widely from state to state. Some states, such as Maryland, have seen proposed premiums increase as much as 91%.

States like Delaware, Indiana and Colorado have seen far lower average increases in the single digits, although many have cited Republican-led policy changes including repeal of the individual mandate as drivers behind higher rates.