Blue Cross NC's Blue Premier program saved $197 million in 2020
The impact of Blue Premier appeared to grow last year as providers made gains in quality and cost measures.
Photo: Sam Edwards/Getty Images
The Blue Premier value-based care program from Blue Cross and Blue Shield of North Carolina created an estimated $197 million in cost savings and quality improvements in 2020, according to the insurer's internal data.
Despite the pandemic, the impact of Blue Premier appeared to grow last year as providers made gains in quality and cost measures, and as additional health systems and physician practices joined the value-based care program.
Collectively, Blue Premier systems and practices met their performance goals for the 857,000 Blue Cross NC members they served last year, the company said. The number of members receiving care from a Blue Premier provider increased 60% from the 536,000 served in 2019, the program's first year.
WHAT'S THE IMPACT?
Blue Cross NC touted a number of specific quality improvements through Blue Premier last year. Among them: a 15% reduction in unplanned hospital readmissions among adult members seeking care at a Blue Premier facility when compared to 2019.
There was also, according to the organization, an increase in the percentage of members who had their blood pressure regularly monitored and controlled – 53% in 2020, compared with 51% in 2019.
The data showed almost 10,000 more colorectal screenings than in the previous year, possibly averting an additional 200 deaths from colorectal cancer, according to health screening calculations from the U.S. Preventive Services Task Force.
The $197 million estimated total impact includes cost savings, quality improvements and a slowdown in the rate of spending on healthcare. It follows $153 million in savings in 2019, giving the program a $350 million impact in its first two years.
THE LARGER TREND
The Blue Premier program, which began in 2019, is a shared risk contract with health systems and their accountable care organizations. The program ties payment to performance: The health systems share in the cost savings if they meet industry-standard goals to improve the health of patients and reduce costs. The health systems also share in the losses if they fall short.
Many Blue Premier providers will begin phasing in shared risk next year, the organization said.
Blue Premier has grown rapidly since its inception: Agreements are in place with 11 hospitals and health systems and more than 870 independent primary care practices across the state, up from five systems in 2019. The systems currently in Blue Premier account for about 65% of Blue Cross NC's total medical expense.
Twitter: @JELagasse
Email the writer: jeff.lagasse@himssmedia.com
