Healthcare IT Interoperability, EHR interoperability, Hospital Interoperability

Private Payers News

Cambia Health Solutions, Blue Cross NC Enter Strategic Affiliation

Cambia Health Solutions and Blue Cross of North Carolina have announced a strategic affiliation to accelerate innovation.

Health plan strategic affiliation

Source: Blue Cross NC / Cambia

By Jennifer Bresnick

- Cambia Health Solutions and Blue Cross of North Carolina have announced a new strategic affiliation that will combine management operations into a single entity retaining the Cambia name.

The two not-for-profit companies hope that the combination will reduce costs and improve quality for consumers while maintaining choice for beneficiaries.

“We have to do something different to make health care better, simpler, and more affordable for the people we serve,” said Dr. Patrick Conway, President and CEO of Blue Cross NC. “By sharing resources, innovations, and best-in-class services we can fundamentally transform the way individuals and families experience the health care system.”

Health plans operated by the two entities, including, Regence BlueCross BlueShield of Oregon, Regence BlueShield in Washington, Regence BlueShield of Idaho, and Regence BlueCross BlueShield of Utah, will continue to be subject to state-level regulation and rate review in order to maintain consumer protections, the companies said in a press release.

The two organizations will now share management, administrative, operational, and other corporate services using the Cambia Health Solutions brand.

READ MORE: CMS Seeks Comment on Purchasing Health Insurance Across State Lines

“People and their families are hurting every day in the current health care system, longing for care focused on their needs,” said Mark Ganz, President and CEO of Cambia Health Solutions. “Together, we have the power to accelerate transformation, be a model for what is possible, and positively impact the lives of those we serve.”

The board will include ten members of Blue Cross NC’s current Board of Trustees and nine representatives from Cambia.

Ganz will take on the role of Executive Chair of the new Board of Directors, while Conway will assume the title of CEO of Cambia.  Conway, the former CMS Deputy Administrator for Innovation and Quality, will also retain his position as CEO of Blue Cross NC.

Together, the two companies will continue to invest in data analytics and population health management strategies to close gaps in care, simplify the consumer experience, and improve the affordability of healthcare services, says an accompanying fact sheet.

The partnership will “build on what each company does best,” Cambia and Blue Cross NC said.

READ MORE: Cigna, Sentara Healthcare Join Payer Blockchain Initiative

“While different, we believe this new arrangement will give consumers the best of both worlds: better, simpler, more affordable care, delivered from the same local presence they already know and depend on,” says the new entity’s website.

Cambia will leverage its experience launching innovative companies and partnerships focused on price transparency, consumer education, and chronic disease management. 

Meanwhile, Blue Cross NC will continue to support the development and deployment of value-based payment models and reducing costs through novel strategies in primary care.

Blue Cross NC recently launched Blue Premier, a collaboration with give major health systems in North Carolina to expand participation in downside risk models.

Cone Health, Duke University Health System, UNC Health Care, Wake Forest Baptist Health, and WakeMed Health & Hospitals, signed on to the program in January of 2019.

READ MORE: Blue Cross, HCSC to Reduce Food Insecurity Among Plan Members

“As a practicing physician, I have experienced first-hand the challenges plaguing our health care system,” said Conway at the time.

“Historically, our health care system pays for services that may or may not improve a patient’s health, and our customers simply cannot afford this approach. Moving forward, insurers, doctors and hospitals must work together, and hold each other accountable for improving care and reducing costs. We applaud the leadership and commitment of these five leaders in health care to help transform health care delivery in North Carolina.”

Blue Cross NC has set the goal of having all of its customers covered under some form of value-based contract within 5 years, and expects to hit the half-way mark by 2020.

Cambia Health Solutions, meanwhile, is a newly-minted member of the Health Care Transformation Task Force (HCTTF), an industry collaborative focused on developing strategies to expand value-based care adoption across the care continuum.

Cambia joined the collaboration alongside Mental Health America, a non-profit founded in 1909 with the goal of improving access to mental healthcare for all Americans.

“We are excited to welcome our newest members to the Task Force during a very important year for value transformation,” said Jeff Micklos, Executive Director, HCTTF.

“Cambia is driving an enterprise-wide commitment to a person-focused and economically sustainable health system in the markets they serve, while Mental Health America brings the patient voice to our table to address some of the most costly, complex, and pressing health needs as we seek to transformation the health payment and delivery system. We look forward to working with both to further our goal of affordable, high-quality health care for patients.”

Blue Cross NC is also a member of the HCTTF.

“Blue Cross NC and Cambia share a common belief that together we can work differently to transform our current health care system,” the companies said. “Working together, we can share resources and expertise, and we can move faster to drive real changes for our customers.”

“Our long-term goal is to make health care more affordable for the individuals and families we serve.  This affiliation provides us the best opportunity to do that.”

The new strategic affiliation is subject to regulatory approval in several states, including North Carolina, Oregon, Washington, Idaho and Utah.  Both companies will retain their corporate headquarters in Portland, Oregon and Durham, North Carolina.


Sign up for our free newsletter:

Our privacy policy

no, thanks

Continue to site...