Wednesday, May 29, 2024

NC Chamber wants to support state’s push for “value-based health care”

Last January Blue Cross Blue Shield of North Carolina announced its Blue Premier program in which five major health care systems agreed to make a big push for “value-based health care.” That’s the moniker for compensating doctors and hospitals based on patient outcomes, not just how many tests or visits can be billed. If their patients stay healthy on average, providers benefit. If patients get sicker, providers share in the losses.

North Carolina wants to the national leader and Blue Cross CEO Patrick Conway emphasized his goal of having all of the insurance company’s members involved in Blue Premier within five years. The New York Times hailed the program in a recent story, praising leadership of Conway and Mandy Cohen, the secretary of the N.C. Department of Health and Human Services.

Since then, Blue Cross hasn’t announced any additions to the network list. Meanwhile, mergers and acquisitions talk among the state’s hospitals is at a fever pitch. Blue Cross itself disclosed a partnership with a Blue Cross affiliate in Oregon in March.

On the positive side, Blue Cross says the value-based care push has contributed to rate decreases recently approved for its individual Affordable Health Care policies (5.5%) and pending for its small-group plans (3.5%.)

The N.C. Chamber wants to help make the value-based push successful, so it’s sponsoring a conference Friday in Raleigh that will assemble Conway, Cohen and many N.C. hospital leaders to discuss what’s going on. The Chamber wants North Carolina to improve its weak record for health care — 33rd for its mix of high costs and weak patient outcomes, according to a United Healthcare survey, chamber CEO Gary Salamido says. Its goal is to move into the top 10, he says.

One key player in the N.C. health care debate who is not on the speaker list at the Chamber gathering is State Treasurer Dale Folwell, who unsuccessfully pressed the state’s hospitals this year to reduce their charges for the 720,000-member State Health Plan. “We wanted to make sure our conference doesn’t pick winners and losers,” Salamido says. “We want to identify the great things going on in the state” related to value-based programs.

Folwell has said more competition and greater public disclosure of hospital costs and prices are more effective ways of addressing health care inflation. Significant State Health Plan spending on preventative care has produced modest benefits, he says.

David Mildenberg
David Mildenberg
David Mildenberg is editor of Business North Carolina. Reach him at

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