BCBS of North Carolina to pay primary care clinics to switch to value-based model


Primary care practices in North Carolina may be eligible for increased financial support from the state's Blue Cross and Blue Shield plan as the insurer rolls out a new program aimed at helping the offices weather the financial crisis spurred by the pandemic.

BCBS of North Carolina launched Accelerate to Value June 24, a program that will send direct payments to help independently owned primary care physician offices remain operational and also transition to value-based care. BCBS said the program will help ensure the long-term viability of primary care in the state.

"Primary care providers across North Carolina are in a financial crisis. We have a duty and a desire to act," Rahul Rajkumar, MD, CMO and senior vice president at BCBS of North Carolina, said in a statement. Independent primary care practices have faced sharp declines in revenue as patients postpone nonemergent treatment due to COVID-19.

Accelerate to Value's direct payments will be based on 2019 revenue and will begin by September. Providers who wish to partake in the program will commit to joining the insurer's value-based reimbursement model, Blue Premier, by the end of 2020. The practices can either join an existing ACO through a Blue Premier clinically integrated network or through Aledade, a firm that helps primary care physicians move to value-based reimbursement models. 

Additionally, starting in 2022, the practices can partake in a capitation payment model, which allows them to receive fixed monthly payments instead of a traditional fee-for-service system.

Applications for the program went live this week.

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