Blue Cross NC brings Blue Premier program to kidney care

Blue Cross and Blue Shield of North Carolina is bringing its value-based care efforts to kidney care.

The insurer unveiled the Blue Premier Advanced Kidney Care program on Thursday, the latest piece of its ongoing Blue Premier value-based care initiative. The program was designed in partnership with Fresenius Medical Care North America and Strive Health.

Blue Cross NC will work with Fresenius and Strive Health to enroll eligible members at no additional cost, and the two will work with primary care providers and nephrologists to identify gaps in care, such as missed preventative appointments.

The program became available on Jan. 1 to members in commercial or Medicare Advantage plans who have stage four or five chronic kidney disease or end-stage renal disease, Blue Cross NC said. Strive Health will serve 85 counties and Fresenius will serve 15 counties.

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“It’s important that we help our members with chronic conditions receive coordinated care, delay or prevent the need for dialysis, and improve their quality of life,” said Von Nguyen, M.D., Blue Cross NC chief medical officer, in a statement. “Advanced kidney disease has long been challenging to treat. Working with FMCNA and Strive Health, Blue Cross NC is bringing an advanced level of care to help our members who need it most.”

The program aims to improve care coordination and member engagement and education around their conditions, according to the announcement. Participating providers will be held accountable for the total cost of care, as well as the quality of care.

Blue Cross NC's Blue Premier program has garnered participation from many of the state's largest providers, including Cone Health, Duke University Health System, UNC Health, Wake Forest Baptist Health and WakeMed Health and Hospitals, all of whom were signed on from the get-go.

Atrium Health, Novant Health and First Health of the Carolinas have also joined the program.

More than half (52%) of Blue Cross NC's members see a provider in a value-based arrangement due to the program, and the insurer found that the program generated $153 million in savings during its first year.