Five major health systems are teaming up with one of North Carolina's largest insurers to launch a new value-based care program.
Duke University Medical Center, University of North Carolina Health Care, Wake Forest Baptist Health, WakeMed Health and Hospitals, Cone Health and their respective accountable care organizations (ACOs) will join the new program led by Blue Cross and Blue Shield of North Carolina (Blue Cross NC).
Under the new program, called Blue Premier, Blue Cross NC and the health systems will be jointly responsible for better health outcomes and patient experiences while lowering costs. The idea is to make providers share risk for higher costs and inefficiencies in the healthcare system in exchange for reaping the rewards of the savings.
The total payments to the health system under Blue Premier will be based on the health systems' ability to manage the total cost of care and their overall performance.
RELATED: Blue Cross, Aledade team up to support independent practices in North Carolina through ACOs
“Historically, our healthcare system pays for services that may or may not improve a patient’s health, and our customers simply cannot afford this approach," said Patrick Conway, M.D., Blue Cross NC president and CEO and the former head of the Center for Medicare and Medicaid Innovation (CMMI), in a statement. "Moving forward, insurers, doctors and hospitals must work together, and hold each other accountable for improving care and reducing costs."
The insurer has an established history of working with the health systems to find ways to drive down costs. In August, Blue Cross NC worked out a deal with UNC Health in a move that reduced premiums on the ACA exchange. However, at the same time, the insurer cut ties with WakeMed and Duke Health by discontinuing its Blue Local exchange.