Blue Cross and Blue Shield of North Carolina says that its value-based care arrangements have generated more than $1 billion in savings since 2019, while delivering meaningful improvements in quality and outcomes.

Blue Cross NC’s value-based care arrangements include:
• Approximately 3 million members receiving care through value-based programs
• Participation from 76% of eligible providers across commercial and Medicare networks
• More than 70 active value-based agreements across primary and specialty care
• Collaboration with 18 of the state’s 20 largest health systems

Since 2019, Blue Cross NC says, it has delivered more than $630 million in shared savings and incentive payments to providers and achieved double-digit improvements in key chronic care quality measures.

“Value-based care is grounded in strong partnerships with providers across North Carolina joining our commitment to bend the cost curve while improving the quality of care our members receive,” said Greg Moon, vice president of provider experience and strategy at Blue Cross NC, in a statement. “Our focus is clear: better care, better outcomes and more affordable coverage, and these results show it’s working.”

Beyond Primary Care

Building on the success of its primary care programs, Blue Cross NC has expanded value-based care into specialty areas, including:
• Advanced kidney care
• Cardiology
• Orthopedics and musculoskeletal care
• Maternity care
• Gastrointestinal care

Blue Cross NC’s work on advanced kidney care was recently highlighted in a case study from The Health Care Transformation Task Force highlighting Blue Cross NC’s Advanced Kidney Care (AKC) program, an outcomes-based model designed to improve care and affordability for people living with chronic kidney disease (CKD) and end stage renal disease (ESRD).

The publication, Advancing Value-Based Specialty Integration Through Advanced Kidney Care, recognizes Blue Cross NC’s integration of specialty care into broader value-based strategies through disciplined measurement, aligned incentives, and patient-centered design. The case study shows that the AKC program reduced healthcare costs by $81.5 million over four years by reducing hospital admissions and avoiding emergency dialysis.

The AKC program is designed to slow disease progression, improve quality of life, and reduce total cost of care by intervening before kidney failure occurs. Blue Cross NC selects providers to serve as an extension of the nephrologist and the broader care team by offering coordinated, patient-centered support that helps patients navigate care, manage comorbidities, and make informed decisions throughout the course of disease.

Supported by full risk-based financial arrangements, the program has contributed to fewer hospital admissions, fewer unplanned dialysis starts, and reductions in overall medical expense, demonstrating how deeply integrated specialty partnerships can improve outcomes for high-risk populations.