5 health systems sign landmark deal with BCBS of North Carolina

Five health systems in North Carolina agreed to share risk under a new reimbursement model with Blue Cross and Blue Shield of North Carolina.

The five health systems are:

Cone Health (Greensboro)
Duke University Health System (Durham)
UNC Health Care (Chapel Hill)
Wake Forest Baptist Health (Winston-Salem)
WakeMed Health & Hospitals (Raleigh)

Under the model, called Blue Premier, payments to physicians and hospitals are tied to the value of services provided. Total payments to the health systems will be based on their collective ability to manage cost of care and quality performance at their systems.

BCBSNC refers to this as a "shared risk" financial model, as the health systems and their ACOs will share in cost savings if they all meet specific cost and quality metrics, and share in losses if they miss the targets.

"The unprecedented commitment from these five large health systems makes Blue Premier one of the most advanced and comprehensive value-based care programs in North Carolina and the nation," BCBS said in a news release.

BCBSNC wants to shift all of its members to Blue Premier value-based care contracts within five years. By early 2020, at least half of its members will have a provider who participates in the shared risk model, the health insurer said.

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