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Health Care Must Evolve
The Affordable Care Act is here to stay. Now that more people than ever are covered, it's time to redouble our efforts to deliver value and control costs. Prices are already higher than many customers can afford.
- Health care costs rank as a top financial concern among American families.1
- Nationally, family health insurance premiums soared by 73% in a decade, and deductibles have more than doubled.2
- Patients are delaying care. Despite having insurance, more than 25% of adults went without needed medical care because they could not afford it.3
- Some Americans are emptying their retirement savings to pay for specialty drugs.4
Together, We've Had Some Great Wins
Blue Cross and Blue Shield of North Carolina (BCBSNC) and providers have already started teaming up. Our efforts have begun to pay off, but it's time for our relationship to evolve.
- Bundled payments result in a 20 percent average reduction in costs and improved quality of care.5
- Having Accountable Care Organizations has meant fewer hospital admissions and ER services.6
- Hospitals participating in quality programs have reduced infection rates by 39%.7
What You Can Do
Here are a few ways you can continue providing optimal care for your patients at affordable costs:
- Refer members to in-network providers whenever possible.
- Prescribe generic prescription drugs when appropriate.
- Recommend services or tests only when absolutely necessary.
- Help educate patients about when to go to an urgent care center vs. the ER.
- Practice value-based care and encourage patients to use their preventive benefits and be active health care consumers.
But Our Toughest Work Lies Ahead
The traditional transaction-based relationship between insurers and providers has contributed to a tremendous rise in health care costs. We owe it to our customers — and your patients — to work toward a better system. One that ties payments to delivering more value to consumers.
Over the next couple of years, you'll notice other changes in the way we pay for health care.
- Aligning payment policies with emerging best practices
- Standardizing fee schedules to address pricing discrepancies
- Taking action to address areas of explosive growth
We're Better Together
We know we have a role to play too. And we will continue to look at ourselves to find ways we can become more efficient and rein in costs. We need you to join us in the fight to keep health care — and health coverage — affordable for N.C. families and businesses.
Did You Know?
- The U.S. spends the most per capita on health care, but our health system ranks the worst in the developed world.8
- The cost of the same surgery in N.C. can vary by nearly $27,000 or more in the same area.9
- The number of Americans using at least $100,000 in medicines has tripled since 2013.10
- BCBSNC spends 87 cents of every premium dollar on customers' health care, consistently exceeding the federal medical loss ratio (MLR).11
1. Gallup, 2015. 2. Commonwealth Fund, 2014. 3. Families USA, 2015. 4. Kaiser Health News, 2015. 5. BCBSNC Internal Data, 2013. 6. BCBSNC Internal Data, 2013-2014. 7. BCBSNC Internal Data, 2014. 8. Commonwealth Fund, 2014. 9. BCBSNC Internal Data, 2015. 10. Express Scripts, 2015. 11. BCBSNC Internal Data, 2014.