Area hospital forms alliance with major insurer [Star-News, Wilmington, N.C.]

Sept. 11--New Hanover Regional Medical Center and Wilmington Health have entered into an accountable care alliance with Blue Cross and Blue Shield of North Carolina. The agreement allows the three organizations to share information regarding best practices, preventive care and cost management.

Wilmington Health was already operating under an accountable care organization with Blue Cross Blue Shield, which insures about 80,000 customers in Southeastern North Carolina. The new arrangement supplements that and raises the number of doctors involved to more than 300.

All three entities say the alliance will improve patient care, increase transparency and lower costs.

John Gizdic, chief operating officer of NHRMC, gave an example: If a patient visited his primary care physician, a specialist and then the emergency department on a weekend, the three medical providers wouldn't have been able to share all the patient's information in a timely manner.

With the new alliance, the emergency department would be able to see instantly what treatments the patient had undergone.

"I think the health care system in general is fragmented," Gizdic said. He said the alliance will reduce repeat tests and duplicate costs.

One facet of the alliance is transparency. Patients will have online access to their own medical records. Another benefit to the alliance is the ability to compile and analyze data across a population of patients in the group.

Gizdic said a clinical analyst will gather information and then compile reports that will help a committee identify trends and best practices. The results could point out the most cost-effective treatment of a disease or the method of treatment that results in the fewest subsequent doctor or hospital visits.

Even patients who aren't Blue Cross customers will benefit, said Jeff James, CEO of Wilmington Health. Once best practices are identified and confirmed, they will benefit all patients, not just Blue Cross subscribers.

Wilmington Health also has an accountable care organization with Medicare, and James credits the alliance with lowering the cost per Medicare beneficiary at Wilmington Health. Gizdic said NHRMC is working toward a similar arrangement.

Gizdic and James said they'd welcome an expansion of the alliance. Darcie Dearth, communication specialist at Blue Cross, said the alliance is regionally based, so expansion would be limited to Southeastern N.C.

"It is something we're interested in," James said. "We'd like to bring all payers into this kind of format. With health care reform, we all need to be able to collaborate."

Mike Voorheis: 343-2205

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