Blue Cross NC's value-based care program saved $197M last year

Blue Cross and Blue Shield of North Carolina's value-based care program, Blue Premier, saved $197 million last year, new data from the insurer show.

Even amid the pandemic, the insurer's program grew, both adding new provider participants and making additional gains in quality and cost improvements, Blue Cross NC said. Blue Premier covered 857,000 Blue Cross NC members in 2020, up 60% from 536,000 in 2019.

The program accounted for $153 million in savings in 2019, the insurer said, for total impact of $350 million in the first two years.

“These results show Blue Cross NC members are benefitting from our move to value-based care,” said Von Nguyen, M.D., Blue Cross NC senior vice president and chief medical officer, in a statement. “Our close collaborations with hospitals and physicians through Blue Premier have resulted in measurable improvement in health care for our members despite the COVID-19 pandemic.”

RELATED: Mission Health signs on to Blue Cross NC's Blue Premier value-based care program

Blue Cross NC said that some specific highlights of the program include a 15% reduction from 2019 in unplanned hospital readmissions among adult members. In addition, nearly 10,000 more colorectal screenings were conducted than in 2019, which could avert 200 deaths from colorectal cancer based on U.S. Preventive Services Task Force calculations.

The program also led to an increase in the percentage of members who had their blood pressure controlled and regularly monitored, reaching 53% in 2020. Fifty-one percent of Blue Premier members reported the same in 2019.

Eleven hospitals and health systems in the state participate in the program, as do 870 primary care practices. Participating providers are working toward shared risk, Blue Cross NC said, with many set to begin phasing in shared risk next year.