August 13, 2020
UNC Health Alliance, LLC (UNCHA) achieved a 100% quality score for the 140,000 Blue Cross and Blue Shield of North Carolina (Blue Cross NC) members attributed to the network, and reduced the overall cost of care for those patients. As a result, UNCHA earns a share of the savings and a quality incentive payment totaling $17.5 million.
The money is earned through UNCHA’s participation in Blue Cross NC’s Blue Premier Alternative Payment Model. Blue Premier is a value-based model of care in which Blue Cross NC and UNCHA providers are jointly responsible for better health outcomes, exceptional patient experience and lower costs.
UNCHA is the clinically integrated network of UNC Health and maintains a network of more than 1,100 primary care providers and 4,100 specialty providers. UNCHA partners with community-based, independent physicians who align with the mission to make care more accessible to patients and shift to value-based payments, achieving high quality patient outcomes at affordable costs.
UNCHA will reinvest part of the $17.5 million into the organization’s infrastructure to support patient needs with services such as medical transportation, enhanced case management, and in-home or telehealth services from physicians, dietitians, social workers and nurses. Further investments will be made in support for the network’s practices such as clinical quality coaching, analytics and technologies to support clinical interoperability. Eighty percent of earnings are shared with the network’s physicians, hospital partners, and other health care professionals.
“These tremendous results are a testament to an incredible amount of quality work and dedicated patient care by our providers and teams, often for the most complex patients in North Carolina,” said Dr. Mark Gwynne, President, UNC Health Alliance. “These outcomes move us closer to our goal of transforming into a health delivery system based on high quality health outcomes while making care more affordable for our patients. Our mission is to improve the health and well-being of North Carolinians, and partnerships like Blue Premier align directly with that mission.”
UNCHA participates in several value-based arrangements with other payers including Medicare. “Our success in value-based programs, including Blue Premier and our Medicare ACO, comes from a focus on expertly managing patient populations, reducing inappropriate utilization and a proactive approach to quality improvement,” said Robb Malone, PharmD, Chief Operating Officer, UNC Health Alliance. “We collaborate with providers to identify improvement opportunities, establish continuous quality improvement programs, focus on the delivery of high value services, and co-manage patients at risk of hospitalization or readmission.”
About UNC Health Alliance
UNC Health Alliance, LLC, is UNC Health’s statewide, physician-led clinically integrated network, and is transforming health care delivery and payment models on behalf of over 6,000 physicians, including community-based, independent physicians along with those affiliated with UNC Health. With a focus on population health management, UNC Health Alliance works closely with physicians, employers, and payers to manage quality, cost and access to care for those living and working in the organization’s service areas.
For more information, please visit www.unchealthalliance.org.
About UNC Health
UNC Health is an integrated health care system owned by the state of North Carolina and based in Chapel Hill. It exists to further the teaching mission of the University of North Carolina and to provide state-of-the-art patient care.
UNC Health is comprised of UNC Hospitals at Chapel Hill, ranked consistently among the best medical centers in the country; the UNC School of Medicine, a nationally eminent research institution; Pardee UNC Health Care in Hendersonville; Chatham Hospital in Siler City; Johnston Health in Clayton and Smithfield; UNC Lenoir Health Care in Kinston; Wayne UNC Health Care in Goldsboro; Caldwell UNC Health Care in Lenoir; Nash UNC Health Care in Rocky Mount; UNC Rockingham Health Care in Eden, Onslow Memorial Hospital in Jacksonville, UNC REX Healthcare and its provider network in Wake County; and the UNC Physicians Network.
For more information, please visit www.unchealth.org.