Primary care's future is looking brighter now that forward-thinking payers are putting their money on it as a means to lower costs and improve health. Here, Brad Wilson, president and CEO of Blue Cross and Blue Shield of North Carolina, tells us why the state's largest insurer is investing in primary care.
By Brad Wilson, President, CEO
Blue Cross and Blue Shield of N.C.
It may surprise you to hear that as an insurer, primary care is a top priority for Blue Cross and Blue Shield of North Carolina (BCBSNC). Think about it: our customers count on us to deliver products that will help them stay healthy and protect their families from financial ruin. And there’s no better way to achieve those goals than by promoting effective primary care. Consider this: our health care system wasted one out of every three dollars spent on health care
last year on things like duplicate tests, and up to 27 percent of emergency room visits are not for actual emergencies
. These are everyday problems that can be solved with more effective, coordinated primary care.
In order to tackle these challenges, we joined Dr. Bill Roper and his team at UNC Health Care in 2011 to build a new primary care practice from the ground up. Our goal was to use what we’ve learned from the proven success of the Patient Centered Medical Home (PCMH) model and take it to the next level to exceed patients’ expectations by improving their health and reining in overall health care costs. The new practice, Carolina Advanced Health,
which is owned jointly by UNC Health Care and BCBSNC, allows patients to see not only their doctor, but also a pharmacist, nutritionist and care manager all in the same visit, and under the same roof. Patients can also find mental health, medication management, and lab services right on site. This not only adds convenience for our customers and patients, but also can help them adhere more closely to their treatment plans. And a BCBSNC customer service professional works on site ready to answer our customers’ questions about their coverage or claims.
From the beginning, we knew success would depend on some key assumptions. Taking a team approach, we’d emphasize patient involvement and allow more time for clinical interaction, patient education and support. We’d also improve quality, reduce total medical expenses, increase patient and provider satisfaction, and identify key practice concepts that could be replicated across the state. And we’d acknowledge that we do not have all the answers. This new practice would foster a “learning lab” atmosphere to continue to improve on the patient experience.
Carolina Advanced Health just celebrated its first birthday, and it continues to grow and teach us new things every day. Dr. Sarah Smithson, a member of the talented team, discusses some of these findings in her recent post
. And every day, we hear from patients who say they have never experienced more convenient, personalized care. “Why aren’t all doctors’ offices like this?” they ask. From an innovation perspective, the information we’re gathering about what works, what doesn’t and what we need more of – and less of – in health care, is most exciting. It’s these discoveries that hold the keys to the future of health care delivery.
When it comes down to it, it’s time that we recognize that the goals of physicians, hospitals, and insurers are quickly becoming one in the same: better health for our patients and customers. And when patients are healthier, health care costs are lower and everybody wins. The sooner we all recognize this, the sooner we can work on new partnerships that make health care better for everyone.
Brad Wilson is CEO of Blue Cross and Blue Shield of North Carolina, the state’s largest insurer. Wilson works with the Council for Affordable Healthcare Quality and the National Institute for Health Care Management to address health care challenges at the national level, among other appointments.