Blue Cross, UNC Health deal will cut rates — and could change health care for all
The two not-for-profit companies say the partnership changes the incentives for providing health care and could serve as a model for other health insurance programs in the state and beyond. Under the arrangement, the insurance company and the health care provider will both be equally responsible for the quality and cost of care, said
"We no longer want to be in an adversarial relationship," Conway said in an interview.
Under the partnership, the two companies plan to eventually move to a model where
Conway and Roper both said the current system rewards doctors and hospitals that provide more care, regardless of the outcome. Roper likened it to the difference between paying a teenager
"That's what doctors and hospitals have done for decades," he said. "We want to get to the world where we're paid a lump sum to keep the patient healthy."
The new Blue Value coverage through the
The cost of each policy will vary based on factors such as a person's age and where he or she lives.
To qualify for the savings, patients will need to get their care through the
"I do understand that there will be a number of patients and families who will ultimately choose to switch care, and that will be a matter of some concern to them," Roper said. "I want to reassure them that we have very fine physicians and providers and hospitals and services that we are proud to offer to them."
Roper said UNC is under tremendous pressure from its customers to reduce health care costs and has made a host of changes, such as negotiating better rates for bulk purchases, improving the flow of patients in its emergency rooms and reducing infection rates. Roper said everything the health system has learned about controlling costs will be applied to Blue Value customers.
"This will be a stretch for us to accomplish all of this and to do it at 21 percent less than we otherwise would be paid," he said. "But we think we can do it. Otherwise we wouldn't have signed the deal."
Both Conway and Roper said their companies will not make up for the lower revenue from ACA patients by increasing prices for other customers. "We're not going to be paid less from
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