A new collaboration between Blue Cross and Blue Shield of North Carolina (BCBSNC) and Wake Forest Baptist Medical Center is focusing on improving the quality of health care and the health of North Carolinians. Through the Center for Healthcare Innovation, these organizations are piloting new health care models designed to improve the quality of health services and overall consumer experience while reining in medical expenses.
“This collaboration allows us to think creatively about transforming the way patients receive care, doctors and hospitals provide care and insurance companies pay for care,” said Susan Weaver, M.D., BCBSNC vice president of health delivery redesign. “Technology and data are rapidly changing the way we live and work but heath care has been slow to harness these tools.”
By combining BCBSNC’s robust analytic capability to identify gaps in care and target high-risk populations, with Wake Forest Baptist’s ability to pilot alternative sites of care and potential to impact a large patient population, the Center for Healthcare Innovation has begun to test programs that deliver cost-efficient care, improve patient health and are scalable across North Carolina and potentially beyond.
“This collaboration with Blue Cross is a perfect example of the type of investment in innovation needed to respond to the economic challenges faced by patients, health care providers and insurers,” said Terry G. Williams, executive vice president, strategy and network development, Wake Forest Baptist Medical Center. “More financial investments in new business models that are value-based and patient-centered are required to bring the result that we seek: improved health for our patients and lower medical expenses.”
The Center creates an open collaboration between BCBSNC and Wake Forest Baptist, which allows the organizations to work hand-in-hand to test new models for providing care by focusing on three primary areas which include:
- Testing new ways of delivering and
coordinating health care at home to reduce the length of time patients have to
stay in the hospital and the likelihood that they will be readmitted to the hospital
or return to the emergency department.
- Exploring opportunities to rein in health
care costs and improve access and ease use of health care services for patients
through more efficient administrative processes.
- Piloting programs that will promote efficient use of health care services by BCBSNC customers and encourage use of preventative services for better long term health.
Hospital readmissions cost the U.S. health care system approximately $25 billion each year. Wake Forest Baptist, BCBSNC and Paired Health, Inc. are working together to address gaps in care following a patient’s hospital stay through the Center’s first pilot program. The program is evaluating new ways to prevent hospital readmissions and emergency department visits, to reduce length of stay and improve patient satisfaction.
Health will work by collaborating with BCBSNC and Wake Forest Baptist to help
providers get care to the right patients, in the right place, at the right
time. Paired Health technologies help Wake Forest Baptist providers with
personalized patient care plans, proactively engage patients in their homes,
and route those same providers across the region as efficiently as
possible. The Paired Health platform
also orchestrates care across supporting team members, such as behavioral
health and pastoral care.
“Wake Forest Baptist Medical Center is pioneering new models of care to ensure that patients receive the appropriate care and support they need when they leave the hospital,” said Thomas E. Sibert, M.D., interim chair of psychiatry and special advisor to the CEO at Wake Forest Baptist Medical Center. “Collaboration is the key. With deployment of this innovation, a team that includes a physician and a case worker in conjunction with community service organizations, our goal is to improve patient-centered care, while reducing readmissions and the cost of that care.”
“We think the Center for Healthcare Innovation is a wonderful idea and smart investment. Now more than ever, we all need to identify better ways to deliver more cost-effective care, so we’re both thrilled and honored to be a part of the Center’s first program,” said Sean Harrison, founder and president of Paired Health, Inc.
The Paired Health initiative builds on work led by Wake Forest Baptist faculty members Jeff D. Williamson, M.D., section director of geriatric medicine and Pamela W. Duncan, Ph.D., director of innovations and transitional outcomes. The initiative includes a variety of programs that help patients receive the medical and environmental resources needed to improve their health.
*All patients ages 18 and older who have multiple complex conditions, such as heart failure and chronic obstructive pulmonary disease, that prevent them from performing usual activities of daily living and who have experienced two or more inpatient discharges in a 12 month period are eligible for participation in the pilot program. Additional criteria may also apply.
 Price Waterhouse Coopers’ Health Research Institute, “The Price of Excess: Identifying waste in healthcare spending,” 2010.
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