Blue Cross and Blue Shield of North Carolina (Blue Cross NC) addresses gaps in care for Medicare Advantage members with ConcertoCare

Blue Cross and Blue Shield of North Carolina (Blue Cross NC) is reminding providers of our ongoing collaboration with ConcertoCare, a tech-enabled, value-based provider of in-home, comprehensive care for eligible Medicare Advantage members. Leveraging a multidisciplinary care team to deploy in-home and virtual visits, ConcertoCare aims to address gaps in care, including but not limited to services such as comprehensive health assessments, urgent care services, 24/7 support, complex care coordination, pharmacy support services, and more. 

ConcertoCare partners with patients and their primary care team to improve health outcomes, prevent hospital admissions and re-admissions, and works to address key medical and social drivers of poor health outcomes, utilization, and cost.

ConcertoCare has seen improved outcomes when caring for patients, including:

• 20% reduction in hospital admissions
• 12% reduction in ER visits
• 9% reduction in hospital re-admissions

The services provided by ConcertoCare are intended to be complimentary to the care delivered by a patients’ primary care team. Your eligible patients will still be assigned, and primarily be managed by you as their primary care provider, with ConcertoCare providing an extra layer of support and service. This program is offered to eligible Blue Cross NC members at no extra out of pocket cost.

For questions, contact ConcertoCare directly at BCNC@concertocare.com or 877-231-2808. 

Commonly asked questions about ConcertoCare

Q: What is ConcertoCare?

A: ConcertoCare is a tech-enabled, value-based provider of at-home, comprehensive care for seniors and other adults with unmet medical, behavioral, and social needs. ConcertoCare orchestrates interdisciplinary teams of nurse practitioners, registered nurse (RN) care managers, social workers, health coaches, and pharmacists to deliver at-home and virtual comprehensive care. These teams partner with and wrap around patients’ existing primary care providers to help keep members in their homes, and out of the hospital.

Q: What are the goals of Blue Cross NC’s collaboration with ConcertoCare?

A: Blue Cross NC’s innovative collaboration with ConcertoCare is focused on providing eligible members with at-home comprehensive care that improves their health outcomes, ensures a more personalized and integrated experience for members and their families, and reduces costs. Additionally, Blue Cross NC and ConcertoCare both share a deep commitment to improving health equity and access to quality care for all members. 

Q: What services make up ConcertoCare’s clinical program?

A:  Using a combination of in-person and virtual member engagement, ConcertoCare’s multi-disciplinary care teams are able to deploy a comprehensive set of services that are tailored to the unique needs of the patient and include, but are not limited to, regular home visits, urgent and after-hours care, care coordination, evidence-based disease care pathways, incorporation of specialist input through consultation, mental health support through dedicated resources, social determinants of health and health equity support, care transition support, and pharmacy support.

Q: What happens to a member’s existing primary care provider?

A: ConcertoCare does not replace the member’s primary care provider. Instead, ConcertoCare wraps around and extends the reach of the member’s primary care provider, collaborating with them to ensure patients experience the best possible clinical outcomes.

Q: Who is eligible?

A: A statewide subset of Blue Cross NC Blue Medicare Advantage℠ members. These members typically require extra support to achieve health goals.  

Q: How were these members selected for inclusion in ConcertoCare’s program?

A:  Blue Cross NC performed a detailed review of statewide Medicare Advantage membership to identify those members who would most benefit from ConcertoCare's clinical program. This review and attribution will continue on an ongoing basis.