Physicians/Specialists
Facilities/Hospitals
Ancillary
Pharmacy
Publication Date: 
2020-07-20

Blue Cross and Blue Shield of North Carolina (Blue Cross NC) and Aledade today announced that their collaboration on North Carolina physician-led Accountable Care Organizations (ACOs) lowered costs and improved quality in the first year of operation.  

Results from the ACOs show that:  

  • Total cost of care fell by 4.7 percent for commercial patients  

  • Total cost of care fell by 6.1 percent for Medicare Advantage patients  

  • Quality of care improved across 47 participating practices serving almost 55,000 patients  

  • Practices collectively earned $10.5 million in incentive payments  

  • Practices improved their Medicare star ratings, on average, from 3 stars to 4.5 stars  

The participating ACOs’ incentive earnings of $10.5 million has proven to be a crucial financial lifeline to primary care physicians on the front lines of the COVID-19 pandemic. ACOs are groups of providers that share financial responsibility for delivering high-quality, better-coordinated patient care.  

In addition to lowering the total costs of care, the practices participating in the North Carolina ACOs achieved significant improvements in the quality of care and health outcomes. These gains were reflected in improved Medicare Advantage star ratings. For example:  

  • From April 2019 to the end of the year, the practices improved their star rating from 3 stars to 4.5, through improved care for patients with chronic conditions like hypertension and diabetes, helping more patients receive cancer screening, and supporting patients after discharge from a hospital stay.  

  • Specifically, practices in the ACOs improved Medicare Advantage star ratings by at least one star in seven categories:  

  • Medication adherence for patients with hypertension  

  • Medication reconciliation post-discharge  

  • A1C Control ≤ 9.0 for patients with diabetes  

  • Adult obesity assessment  

  • Attention to nephropathy for patients with diabetes  

  • Colorectal cancer screening  

  • Recommended therapy for patients with Rheumatoid arthritis.   

For more information, click here to read the press release.