Foundation Grant Focuses On Primary Care Shortage

• Did you know that North Carolina will need 4,700 family physicians by 2020?

The Blue Cross and Blue Shield of North Carolina (BCBSNC) Foundation has provided a $1.18 million grant to the N.C. Academy of Family Physicians (NCAFP) Foundation for a mentoring program to help address the shortage of family physicians in North Carolina. Through this grant, NCAFP will increase medical students' exposure to innovative practice in family medicine and encourage more of the state's medical students to pursue a career in family medicine, ultimately ensuring that more North Carolinians have access to high quality primary care.

Health care reform legislation will increase the number of North Carolinians who are insured and who seek regular primary care, exacerbating the shortfall of primary care physicians. A 2006 American Academy of Family Physicians Workforce Study estimated that the United States will need approximately 39,000 more family physicians by 2020. North Carolina now has about 2,700 family physicians, with projections indicating the state will need 2,000 more by 2020 in order to address the state's health care needs. While the number of family physicians in North Carolina is growing, current rates of growth would only meet 75 percent of the projected need.

"Communities across North Carolina work hard to attract quality physicians to provide primary care for our citizens," said Brad Wilson, chairman of the BCBSNC Foundation. "However, we are already faced with a national shortage of primary care physicians, and the recently passed health care reform legislation will mean an increase in the number of folks seeking care. We hope that through this initiative, North Carolina medical students will receive the help and incentive they need to make a commitment to family medicine."

The $1.18 million grant supports the establishment of the Family Medicine Interest and Scholars Program, a two-tiered effort to help increase the number of North Carolina-trained medical students who elect family medicine residency programs and go on to practice in the state.

"With the urgent need for more primary care physicians, we are proud to support a program that will have a real impact on this state," added Kathy Higgins, president of the BCBSNC Foundation. "Identifying students early who are interested in a career in family medicine and helping them reach that goal will in-turn benefit communities all across North Carolina."

The program aims to increase the percentage of medical students who commit to a residency in family medicine by approximately 30 percent and the percent of those who elect to stay in the state for their residency training from 56 percent in 2008 to at least two-thirds over the length of the six-year program. This grant is expected to yield a significant return on investment. According to the Robert Graham Center for Policy Studies, the annual economic impact of one new family physician to the state of North Carolina is more than $950,000.

The program will provide North Carolina medical students with role models in family medicine, pairing them with innovative family physicians in clinical practice settings. These physician mentors will work with students for three consecutive years to strengthen skills, offer guidance and help fast-track their health care leadership training and experience.

The program also targets a broader audience of medical students to increase interest in family medicine by improving and increasing interaction between practicing family physicians and students at each of North Carolina's four medical schools.

"The North Carolina Academy of Family Physicians is committed to improving primary and family health care in North Carolina and our hope is that this program sparks the health care industry to look for more innovative ways to address the primary care shortage in our state," said Greg Griggs, executive vice president, NCAFP. "We understand that pursuing family medicine is often not an easy choice for medical students. We believe this grant will help make family medicine more of an option for North Carolina medical students. And the access to dedicated mentors will help these students provide quality medical care to patients across the state."

Students who participate in the scholars program will also receive additional exposure to family medicine throughout their schooling, including additional clinical experiences, and will have the opportunity to access scholarship funding if they ultimately enter a family medicine residency program.

The NCAFP Foundation has identified the students and mentors participating in the program for the 2010-2011 academic year.

BCBSNC Recognizes Hospitals For Excellence In Surgery

Blue Cross and Blue Shield of North Carolina (BCBSNC) is continuing to focus on improving health care quality by recognizing select North Carolina hospitals for excellence in spinal surgery, knee replacements, and hip replacements. The goal of the program is to help BCBSNC members choose facilities that meet high standards for these common procedures.

These 10 Blue Distinction Centers for Spine Surgery^SM and 16 Blue Distinction Centers for Knee and Hip Replacement^SM are part of an expansion of the Blue Cross and Blue Shield Association's Blue Distinction^® program. BCBSNC has similar Blue Distinction programs for excellence in weight-loss surgery, heart care, certain cancers and transplants.

"When you're facing surgery, you want to rest assured you're going to the best hospital you can," said Dr. Don Bradley, chief medical officer and senior vice president for BCBSNC. "These Blue Distinction Centers can give our members some peace of mind, because they know the hospital has met high standards for coordinating patient care, training physicians, and educating patients and involving them in their care. We recognize these facilities not only for the volume of procedures they do, but for the superior expertise that comes from this experience."

The North Carolina hospitals recognized as Blue Distinction Centers for Knee and Hip Replacementare:

• Cape Fear Valley Medical Center in Fayetteville
• Carolinas Medical Center in Charlotte
• Carolinas Medical Center, Mercy, in Charlotte
• Duke University Hospital in Durham
• Forsyth Medical Center in Winston-Salem
• Gaston Memorial Hospital in Gastonia
• Granville Medical Center in Oxford
• Mission Hospital, Inc. in Asheville
• Moses H. Cone Memorial Hospital in Greensboro
• North Carolina Baptist Hospital in Winston-Salem
• Northern Hospital of Surry County
• Presbyterian Hospital – Huntersville
• Presbyterian Orthopedic Hospital in Charlotte
• Rowan Regional Medical Center, Inc. in Salisbury
• UNC Hospitals in Chapel Hill
• Wesley Long Community Hospital in Greensboro

The North Carolina hospitals recognized as Blue Distinction Centersfor Spine Surgery are:

• Duke University Hospital in Durham
• Forsyth Medical Center in Winston-Salem
• Gaston Memorial Hospital in Gastonia
• Mission Hospital, Inc. in Asheville
• Moses H. Cone Memorial Hospital in Greensboro
• Presbyterian Hospital – Huntersville
• Presbyterian Orthopedic Hospital in Charlotte
• UNC Hospitals in Chapel Hill
• WakeMed Raleigh
• WakeMed Cary

1 Agency for Healthcare Research and Quality (AHRQ) Statistical Brief #34, Hospital Stays Involving Musculoskeletal Procedures 1997-2005, July 2007

Note: Designation as Blue Distinction Centers means these facilities' overall experience and aggregate data met objective criteria established in collaboration with expert clinicians' and leading professional organizations' recommendations. Individual outcomes may vary. To find out which services are covered under your policy at any facilities, please contact Blue Cross and Blue Shield of North Carolina.

Audit: BCBSNC Provides Value To State Health Plan

The consulting firm Navigant has released an extensive report detailing its audit of BCBSNC's administration of the State Health Plan. BCBSNC administers health benefits for over 660,000 State employees, teachers, retirees and their dependents. The Navigant audit was mandated by the state General Assembly during the 2009 session.

The purpose of the audit was to examine a portion of the 5 percent of the State Health Plan's budget that goes to pay administrative costs to BCBSNC and Medco Health Solutions, Inc., the State Health Plan's pharmacy vendor. The audit covered the period from July 2005 through June 2008.

"Like others before it, the Navigant audit confirmed that we are living up to our contract with the State Health Plan and providing quality service at a fair price," said Ian Gordon, senior vice president and chief operations officer at BCBSNC. "Blue Cross earns less than a penny of profit on each dollar we receive to administer the State Health Plan. The price the State pays us to administer the plan has declined during the contract term."

Navigant's audit was the third in 12 months to examine BCSBNC's fulfillment of its contract with the State Health Plan. While the Legislature controls benefits and premium levels for the State Health Plan, BCSBNC provides administrative services including claims processing, customer service, processing appeals, enrolling and billing customers, managing networks of doctors and hospitals, and information technology services. Navigant's audit examined all of these areas.

Key findings of the Navigant audit include:

• The current "cost-plus" contract saved the State Health Plan money over the course of the audit period, compared to what the State would have paid under a fixed-cost arrangement.
• BCBSNC's costs to provide customer service, claims administration, information technology services and accounting services to the State Health Plan are consistently better than at least 75 percent of benchmarked plans.
• If BCBSNC implemented all Navigant's recommendations, BCBSNC's total administrative costs could potentially be reduced by approximately 1 percent each year over the next four years (not including costs of implementation.)
• Overall, BCBSNC was compliant with its contract terms, state law and all relevant regulations in its administration of the State Health Plan.
• BCBSNC's cost-allocation methodology is consistent with the contract between the State Health Plan and BCBSNC, BCBSNC's other lines of business and industry standards. This finding confirmed identical findings in previous audits by the North Carolina State Auditor and Thomas & Gibbs.

Resource Kit: 'A Guide To A Healthier You' (PDF)

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BCBSNC Launches 'Strive To Survive'

Blue Cross and Blue Shield of North Carolina (BCBSNC) is making available 20 Automated External Defibrillators (AED) to Charlotte area places of worship through the "Strive to Revive" program.

Strive to Revive is a BCBSNC led collaboration of several organizations that are partnering to support the initiative, including Bank of America, Carolinas HealthCare System, Duke Energy Carolinas, Mecklenburg County Farm Bureau, Mecklenburg EMS Agency (Medic), Mecklenburg Medical Alliance and Endowment (MMAE), NC Association of Electric Cooperatives, Piedmont Natural Gas, Progress Energy, Reynolds American and UNC Charlotte University Relations and Community Affairs.

This initiative will support The Lucky Hearts Campaign—a public education collaborative of Medic and MMAE. Lucky Hearts will lead the application process, the AED distribution as well as providing essential training as part of their overall AED awareness program that has been increasing access to the machines in Mecklenburg County since 2008.

Strive to Revive seeks to increase the chance of survival of sudden cardiac arrest patients through training and bystander intervention. The program focuses on places of worship, as consistently large gathering places, and is designed to impact populations which may disproportionately be impacted by heart disease, cardiac arrest and other health risk factors or disparities.

The program was adopted after Mark Fleming, director of Government Affairs at BCBSNC, was one of the first responders to Representative Becky Carney in April 2009, when she collapsed in her legislative office and went into cardiac arrest. Her life was saved because a portable defibrillator was available at the time of the incident.

Rep. Carney's experience raised awareness of the importance of AED's and has led to this convening of organizations committed to ensuring that more people in Charlotte have access to these life-saving devices.

"I am pleased a new program will save lives by increasing the number of portable defibrillators in Charlotte. I know how important it is to have these devices in public places. I am living proof that a defibrillator will increase the chance of survival to anyone that may experience cardiac arrest in a public setting," said Rep. Carney.

Organizations interested in applying to receive an AED via this initiative can simply visit the Lucky Hearts Web site ( www.luckyhearts.com ) for more information.

Criteria for eligibility include:

• Mecklenburg County-based house of worship
• Serve a population largely at risk of health disparity or poor health outcomes
• Demonstrated need (large congregation, limited financial resources, etc)

An AED is a computerized medical device that is used to check a person's heart rhythm. It tells the rescuer when a shock is needed by using voice prompts, lights and text messages. AED's are very accurate and easy to use. When they are used correctly, these machines can increase survival rates of heart attack victims by nearly 50 percent.