Effective January 1, 2025, Blue Cross and Blue and Blue Shield of North Carolina (Blue Cross NC) expanded the Blue Premier Advanced Kidney Care Program to include an additional diseases stage and included an additional Service Provider. The program, originally announced in this provider news, launched in 2021 to improve care for members with late-stage kidney disease.
The expansion of the program adds disease stages to include Chronic Kidney Disease (CKD) stages 3b in addition to the existing stages 4, 5 and End Stage Renal Disease (ESRD). The updated vendors supporting this program include Strive Health, Interwell Health and Somatus.
General Information about the Blue Premier Advanced Kidney Care Program
As a provider, do I have to do anything related to this program?
One of the AKC Service Providers’ major responsibilities is establishing collaborative working relationships with primary care and nephrology practices. We are notifying you of this new program so that you are aware prior to the Service Providers contacting you. We also hope this information will help you have conversations with and answer questions from your eligible patients.
What members are eligible for this program?
Members with a diagnosis of CKD stage 3b, CKD stage 4, CKD stage 5, or ESRD receiving dialysis services in North Carolina who have primary coverage through a Blue Cross Individual U65, Local Group, Major Group, FEP, or Medicare Advantage plan are eligible for the program.
Members with SHP, IPP/HOST and Medicaid plans are not eligible, although we aim to expand to these segments in the future.
When our members work with an advanced kidney care service provider, the member will have a partner to coordinate and work with their existing care team – ensuring the member gets the high-quality care and education he/she needs to help better manage kidney disease.
Working an advanced kidney care service provider can:
- Slow or prevent kidney disease progression
- Help ensure a smooth transition to dialysis or transplantation (when applicable)
- Reduce expensive and difficult complications
- Help coordinate ALL chronic conditions a member may have, not just kidney disease
Providers can reach out to the Value Programs AKC team at advancedkidneycare@bcbsnc.com if they have additional questions.
