The move to value-based care is lowering ACA rates
Health care is far more expensive in the U.S. than other developed countries. Why? Because everything is so…expensive. We pay more for tests, procedures and medical devices. More for prescription drugs. And more for doctors’ and nurses’ salaries. In fact, in 2016, the U.S. spent nearly double on health care compared to other high-income countries.1
It might come as some consolation if we went to the doctor or hospital more than other countries (we don’t), or if we were healthier (the opposite is actually true).2 Or if the health care system otherwise used our money wisely (not so much, considering an estimated $1 trillion in health care spending was wasted in 2016 alone).3
Clearly, maintaining the status quo is out of the question. That’s why we are doing our part to transform health care here in North Carolina, starting with our Accountable Care Act (ACA) plans.
Hope on the horizon.
For the past several years, ACA plan premiums have increased by double digits. Now, for the first time since Blue Cross NC entered the current individual market, 2019 rates for individual (Affordable Care Act) plans will be decreasing. The overall average rate decrease will be 4.1 percent. How was this reversal made possible?
We know that the key to lowering premiums is reducing health care costs like the cost of tests, procedures and hospitalizations. In creating 2019 ACA plans, we sought out health care systems that could provide our customers with the lowest rates while continuing to offer them access to the highest quality care. In doing so, we were able to reduce pre-subsidy premiums in the Triangle by an average of 21 percent, and Charlotte and Gastonia by an average of 16.5 percent.
In the greater Triangle region, we are partnering with UNC Health Alliance, which will also enable us to share data to streamline customer care and minimize inefficiencies. As this arrangement evolves, combined with the value-based care models in flight, Blue Cross NC eventually plans to transition provider organizations to a structure where they are responsible for the total cost and quality of care. This enables health care providers to provide the best care as they see fit while cutting costs by reducing unnecessary tests, duplicate care and avoidable errors.
While value-based arrangements like this are currently the exception, they are expected to become the rule in the future. Aside from improving care and lowering costs, they’ve been shown to make for a better patient experience.
We still have a long way to go to make care better and more affordable for everyone. But this is a promising step in the right direction. One of many to come.