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5 Ingredients for Better, Simpler, More Affordable Health Care

Tunde Sotunde, president and CEO of Blue Cross and Blue Shield of North Carolina, shares five ingredients critical to successfully transforming the health care system.

7 min read | Industry Perspectives, Thought Leadership

Behavioral health care is in crisis – but payers have the opportunity to shape a better future.

Payment reform can drive the development of a behavioral health system that is flexible and responsive, especially during times of higher demand.

5 min read | Industry Perspectives, Behavioral Health, Thought Leadership, Transforming Healthcare

Supporting Latino Communities Through COVID-19

Latino communities are facing health disparities during COVID-19. So two Blue Cross NC partners stepped up to make sure their communities were not left behind.

5 min read | Community Health, Community Partners, Investments, Public Health Challenges

Diversity, Equity and Inclusion: Our Work Doesn’t Stop!

At Blue Cross and Blue Shield of North Carolina, we can’t fulfill our mission to improve the health and well-being of our customers and communities without explicitly addressing disparities and health inequities.

2020 in Review: A Year of Heartbreak and Heroism

2020 was heartbreaking, but it also brought out the best in so many people. During one of the most serious public health crises in a century, health care professionals rose to the challenge.

How Blue Cross NC is Reshaping Behavioral Health Care in NC

Blue Cross NC is in its second year of a long-term strategy to improve behavioral health access, quality and efficiency by focusing on whole-person care.

Using High-Tech and High-Touch to Simplify Health Care

Blue Cross NC is using technology and human interaction to help provide a simplified health care experience.

Drug Maker’s Guilty Pleas Won’t End the Opioid Crisis

The settlement with Purdue Pharma, maker of OxyContin, is an important step forward in managing the nation’s opioid crisis. Learn more.

Pulling Back the Curtain on Health Care Costs

Managing medical costs starts with knowing what they are in the first place. We support the concept of cost transparency, and we’re leading the way in making it a reality for all North Carolinians.

Making health care simpler and more affordable starts with value

In order to make health care better, simpler and more affordable, the health care system needs to fundamentally change. This transformation starts with a move to value-based care.

Data To Go: Health Records Should Be Accessed Like Bank Statements

As part of our efforts to transform health care, we’re working toward interoperability — allowing physicians to access patient data across practices, hospitals and platforms to paint a full picture of a patient’s health.

Three Things COVID-19 Has Confirmed About Health Care

The COVID-19 crisis is teaching us a lot about our health care system, and we will emerge from this crisis wiser for the experience. Blue Cross NC’s COO explains where we go from here.

Expanding Access to Treatment for Substance Use Disorders in North Carolina

Blue Cross NC is committed to combating the substance use disorder crisis in our state through community partners, new solutions and industry-leading approaches.

The Costs of Surprise Medical Billing

Providers deserve to be paid fairly to treat patients. But we can all agree that sending huge surprise bills or engaging in medical price-gouging isn’t right.

Health Care in 2020: The Only Thing That’s Certain is Uncertainty

Blue Cross NC’s chief financial officer Mitch Perry talks lowering rates for members and looking toward the future of health care during the pandemic and beyond.

New Report Shows Maternal Health Continues to Trend in the Wrong Direction

There is work to be done to maximize the chances of healthy pregnancies and births in North Carolina and beyond.

Is Social Distancing Weakening Our Immune Systems?

Social distancing and wearing masks reduces exposure to germs and bacteria. Does less exposure weaken our immune systems?

Managing Chronic Pain During the Pandemic

The pandemic is making it more challenging for people dealing with chronic pain to receive the care they need. Here’s why.

When is it safe to return to the doctor during covid-19?

During the covid-19 pandemic, many of us have been told to “stay home.” Now, as the state begins to reopen, is it safe to return to the doctor?

An Employer’s Playbook For Supporting Employees Post-COVID

Employees are experiencing difficulties because of COVID-19. Here’s how to play an active role in supporting your employees’ mental health needs.

Facts Make Us Safer. Here’s How to Find Them.

Right now, one of the best defenses we have against COVID-19 is accurate information. Learn how to become a coronavirus fact checker.

5 COVID-19 Scams to Stay Away From

Scams are common during the coronavirus pandemic.

5 Things Businesses Are Already Learning from the COVID-19 Crisis

Life during the COVID-19 outbreak is changing our lives in ways we hadn’t contemplated before now.

Ten Years of the Affordable Care Act

It’s been ten years since the landmark passage of the Affordable Care Act, and six years since the Marketplace opened and Blue Cross and Blue Shield of North Carolina (Blue Cross NC) began selling individual plans on the federal marketplace.

Maintaining Strength & Stability for Our Customers in 2019

With spring approaching, we’re entering the season when many Americans file their taxes. At Blue Cross Blue Shield of North Carolina (Blue Cross NC), this time of year marks the preparation and filing of our yearly financial results. Each year, this filing provides us with the opportunity to reflect on our performance and how we’re […]

Generation Y: Answering Three Critical Questions About Millennials and Behavioral Health

With today’s technological advances, medical innovations, and unprecedented access to information, you might expect millennials, who were born between 1981 and 1996, to be ahead of the curve when it comes to their own health. However, according to a report by the Blue Cross Blue Shield Association (BCBSA), the opposite is true. Focusing on the […]

A Time for Change: Addressing the Drivers of Health

Around 2,500 years ago, Hippocrates detailed the relationship between our living environment and our health in his book On Airs, Waters, and Places. In the book, the great physician and philosopher offered guidance to doctors who traveled the countryside, advising them to consider a range of factors that have a significant impact on health and […]

Rising to Meet the Challenges of Addiction Treatment

Finding and receiving treatment for addiction is one of the most difficult health care encounters a person can face. Patients and their families often don’t know where to turn with their questions about substance use disorders. Questions like: How do I know what type of treatment will work? What kind of care do I need? […]

Flu Shots: We Debunk Some of the Biggest Myths

Flu season is already here and according to health experts, getting your flu shot this year will be critical. ABC News reports that only half of American adults plan to get the shot. The importance of getting the vaccine right to protect against influenza can be seen in our own backyard as Duke announced a […]

What to Know About our 2020 ACA Plans

It’s official: we’re lowering rates by an average of 5.5 percent for 2020 Affordable Care Act (ACA) plans offered to individuals. The North Carolina Department of Insurance has approved our reduction, making this is the second year in a row that we have decreased average rates for individual ACA members. Our average rate reduction for […]

We Must Solve the Opioid Problem Without Making the Pain Problem Worse

“Pain is inevitable. Suffering is optional.” Scholars differ on the origins of that quote, but that debate doesn’t change the core truth being expressed. Humans can’t expect to live a life without pain; to be alive is to hurt. Fortunately, science has delivered some very effective ways of minimizing our physical suffering. And there is […]

Improving the Health of America Starts in Our Communities

One of the most rewarding parts of being a Blue Cross and Blue Shield of North Carolina (Blue Cross NC) employee is knowing that our work is making a positive impact in the lives of millions of North Carolinians.

4 Tips To Help You Discuss Your Mental Health with Your Doctor

You talk to your friends about your life, your frustrations and they offer advice. Your friends know you well, and it’s easy to find comfort in talking about your deepest fears and troubles with people you trust. As a psychiatrist, patients enter my office with some awareness that they may need assistance to get unstuck. […]

Breaking Stigmas With Education: FAQS On Mental Health and Substance Use Disorders

As a psychiatrist, I often come across confusion around my field of work: behavioral health. In my experience, people want to learn more, but don’t know where to start. People wonder, what do I ask? What do I need to know? What if I sound ignorant asking? I thought it would be helpful to collect […]

We can do better to support working parents

As the Chief People Officer at Blue Cross NC, a lot of my job involves talking to employees, really listening to what struggles they are having, and working with my team to create innovative solutions to how we, as a company, can help our employees live their best lives. A lot of the people I […]

Warning Signs for Parents Concerned About Teenage Opioid Abuse

The opioid epidemic gripping North Carolina is not only affecting adults or users of street drugs or illegal narcotics. Prescription opioid medications are responsible for more deaths than heroin and cocaine combined.[1] In 2017 alone, more than five North Carolinians died each day from an accidental overdose. That same year approximately 15 percent of N.C. […]

Introducing Blue Premier: Redefining What is Possible in Health Care

Health care is evolving at a rapid pace and we recognize that this can leave North Carolinians with tough choices to make. For 85 years, Blue Cross and Blue Shield of North Carolina (Blue Cross NC) has remained committed to advocating for our customers on issues of health care costs and access to care. Better […]

Passing Rebates Back to Customers to Lower Drug Costs

Over the past five years, drug costs as a percent of total health care dollars have increased 30 percent. These increases have caused prescription drugs to become more costly for many individuals and families. To help, starting January 1, 2019, Blue Cross NC will be passing back drug rebates directly to customers when they buy […]

The Numbers Don’t Lie: Drug Prices Are Nuts

If you were going to draw up an economy that makes absolutely no sense, you’d start with a system where prices go up as demand goes down. That’s nuts, right? Welcome to the world of prescription drug pricing. Data from Blue Cross and Blue Shield of North Carolina (Blue Cross NC) and the Blue Cross […]

The Opioid Epidemic: Access Expands for Medication-Assisted Treatment

One way to reduce the impact of the opioid epidemic is to ensure that people have access to safe therapies that treat opioid use disorder. To that end, Blue Cross NC is taking steps to help patients get the care they need while ensuring their safety. On Nov. 1, we stopped requiring doctors to get […]

North Carolina Can’t Wait Any Longer for Value-Based Health Care

During my first few months as chief strategy and innovation officer at Blue Cross and Blue Shield of North Carolina (Blue Cross NC), I’ve been struck by the energy behind transforming health care in North Carolina. And it was inspiring to see 160 business leaders show up recently at Triangle Business Journal’s Health Care Summit […]

Trump Administration Medicare Drug Price Announcement Is a Good First Step – Here’s Why It Matters

We welcome the Trump Administration’s recent announcement of a pilot effort to rein in Medicare spending on prescription drugs. This is a reasonable first step toward getting spiraling drug prices under control. After all, prescription drug spending is growing faster than any other category of health care costs. As part of this pilot, Medicare will […]

Do You Know What Your Body Mass Index Is?

Body mass index (better known as BMI) is a measurement – based on a person’s height and weight – used to indicate if a person is underweight, overweight or obese. Knowing your BMI is an easy and quick way to target a healthy weight.

North Carolina Has an Opioid Problem, How Did We Get Here?

“We are often loathe to give liberal amounts of narcotics because the drug addiction itself may become a hideous spectacle.” Those words were written by Warren Cole, MD, FACS, in 1956 for a book describing cancer pain treatment in the mid-20th century. In Dr. Cole’s day, physicians were trained to prescribe pain medications sparingly, or […]

The Facts about Falling

The first day of Fall is also is Falls Prevention Awareness Day! Although you may think that falling is minor, the fact is that falls can cause serious injuries and death, especially among the elderly. So, it’s important to know the facts about fall-related injuries and tips to prevent falling. Did You Know? More than […]

What is Medication Management? Tips to help you stay organized

Medication management is the process of staying up-to-date on the medications you are taking. The term “medication” refers to any prescribed, over-the-counter, dietary supplements, vitamins, herbals, or other substances you are taking to help manage or maintain your health.[1] Why is it important? Over 60% of seniors have multiple chronic conditions and nearly 20% of […]

What you need to know about our 2019 ACA plans

We are lowering health care costs for many of our individual ACA customers. Statewide, we are lowering rates by an average of 4.1 percent. [button link=”http://mediacenter.bcbsnc.com/news/blue-cross-nc-unc-health-alliance-agreement-lowers-triangle-aca-rates-by-more-than-21-percent” type=”icon” color=”lightblue”] We reached an agreement with UNC Health Alliance to lower individual ACA rates in the Greater Triangle Region by more than 21% before subsidies. Benefits are staying […]

You Have Questions About Opioids in North Carolina – We Have Answers

Over the past year, Blue Cross and Blue Shield of North Carolina (Blue Cross NC) has tried to foster a conversation with consumers about the opioid epidemic…

Sticking with you through ACA ups and downs

The Affordable Care Act (ACA) came to North Carolina in 2014. It has had its ups and downs. But we stayed in when times were tough, and you stayed with us. Through it all, we were led by our mission of improving the health and well-being of our customers and communities. Now today, we are […]

Preventive Health – It’s Not Just for Kids

The good news is, Americans agree nearly unanimously on two things. The bad news is, one of those things is potentially dangerous: It’s vital for children to get routine exams. Check-ups don’t really matter much after childhood. Health screenings are crucial not only to gauging kids’ health as they grow, but they also allow health […]

On Opioids, North Carolina Is Making Progress

The opioid problem won’t be solved overnight. But that doesn’t mean we can’t make significant progress in the short term here in North Carolina.   A research report called “The Opioid Epidemic in America: An Update” from the Blue Cross and Blue Shield Association (BCBSA) published this week shows that the total number of opioid […]

Preventing Child Abuse Is A Healthy Investment For All

The foundations of life are literally built in early childhood. A vital and productive society with a prosperous and sustainable future is built on healthy child development. Health in the earliest years—beginning with the future mother’s well-being before she becomes pregnant—lays the groundwork for a lifetime of vitality.  The Blue Cross and Blue Shield of […]

From Army medic to Physician Assistant: Helping transform NC’s medical deserts

Imagine this scenario. You’re in a combat zone. You have to tend to the gunshot wound of a fellow soldier with little more than a bag of medical supplies to help you. It’s not exactly a sterile environment – think desert conditions, sand, and dirt. Then you have to carry this wounded soldier, likely a […]

Doctors Working at an Insurance Company? Yes, and Here’s Why

I’m lucky to have a career in medicine that gives me the chance to see the health care system from a lot of different angles, including the patient and family perspectives. As a pediatrician who is still practicing, I hear directly from parents who are struggling to get the best care for their families – […]

What you need to know about tobacco in 2018

For centuries, tobacco has been a main crop in North Carolina. A lack of soil quality and fewer plantation-style farms helped tobacco farmers thrive. An accident led to the discovery of “bright-leaf”, a form of tobacco preferred by smokers, which caused the state to begin focusing mainly on tobacco and not on other crops. As […]

The Truth About Drug Companies’ Influence on Your Doctor’s Prescriptions

These days, it seems like every TV commercial break is filled with nothing but ads for medications. Drug firms spend a lot on marketing. In 2013, Johnson & Johnson – the drug company with the highest annual revenues – spent $17.5 billion on sales and marketing. That’s more than double the $8.2 billion they spent […]

Weak Bones, Oh No! – Osteoporosis 101

Since a young age, our parents always stressed the value of having strong bones.

How to Unlock Artificial Intelligence in Health Care

At our recent Tech Summit, I spoke about one of technology’s top trends, artificial intelligence. It’s playing a bigger role than ever in health care. You just might not recognize how. From improving health care processes to predicting when you might need to go into the hospital, AI is improving many aspects of the way […]

High Blood Pressure: What You Need to Know about the Silent Killer

As humans, we believe that what we can’t see, can’t hurt us. We are wrong. What we can’t see, can sometimes be the deadliest. This is especially true when it comes to medical conditions and diseases. For years, doctors have been referring to high blood pressure as the “silent killer.” The condition impacting one in […]

Changes to our Opioid Policies

Every day, opioid addiction destroys lives and tears apart families in North Carolina. It is a public health emergency that Blue Cross NC is committed to addressing. We’re announcing three policy changes for opioid prescriptions and treatment for opioid dependency. These changes will help prevent addiction, treat dependency, and save lives. The three changes are: […]

Read Your Way to Better Health

Want to help your kids turn into healthy adults? Make sure they become good readers. That’s right. There’s a link between literacy and health. According to research by the National Institutes of Health, poor reading ability is likely to lead to poor health. Reading is a healthy habit If you have kids and don’t routinely […]

The opioid epidemic: How we’re turning talk into action

The opioid epidemic is one of the most talked-about and devastating problems we face every day in North Carolina. For the longest time, it seemed like there was a lot of talk and not a lot of action. Political and community leaders, law enforcement, and health care organizations saw firsthand how critical the problem was […]

Thinking Broadly About Investing in Health

Often, when people think about what shapes a person’s health, they think about routine doctor visits, medications, and exercise—things largely within the control of our doctor and us. But there are many other circumstances at work. Where we live, how safe or stressful our environments are, our access to quality education, healthy foods, transportation, community […]

Everybody Hurts: 5 Things You Might Not Know About Pain

In the old days, life often began with an introduction to an unpleasant sensation called pain. A doctor would grab a newborn baby and give the child’s rear end a slap. When the child squealed in response, everyone would hear proof that the lungs were working just fine. From the first time we experience that […]

Addressing Social Needs to make Health Care More Affordable

As a practicing physician, I’ve seen how investments to improve early childhood development and address social determinants of health lowers costs and improves health outcomes. One big question in health care today is “How can we make it more affordable?”  There are some obvious answers: Making sure hospitals and doctors are paid to keep people […]

What We Are Doing With Our Tax Savings

It’s true. Blue Cross and Blue Shield of North Carolina (Blue Cross NC) is a not-for-profit health insurer. But we do pay taxes. In fact, we are fully taxed. We paid more than $500 million in federal, state and local taxes in 2017. Our tax rate is now lower since Congress passed the Federal Tax […]

A best-in-class experience starts here

Since moving to North Carolina a few months ago, my family and I have enjoyed getting to know our state and the people who make this such a great place to live. Given my role as president and CEO of Blue Cross and Blue Shield of North Carolina, I’ve made it a point to ask […]

The Perfect Storm for a Severe Flu Season

The 2017-2018 flu season has turned deadly. According to the Centers for Disease Control and Prevention (CDC), there has been “widespread” flu activity across the United States. Reports show that over 60,000 samples have tested positive for the flu and over 1,200 people have died due to flu-related complications. North Carolina has accounted for 2,500 […]

How Should We Define “Value” in Health Care?

In health care we haven’t always focused on improving quality, lowering costs, and offering a better consumer experience. This is finally changing, and I’m optimistic about what this progress means for delivering better value for patients. Value has become a key topic in health care. That was certainly the case at the annual Forbes Healthcare […]

Blue Cross NC and Mission Health Reach New Agreement

Blue Cross and Blue Shield of North Carolina (“Blue Cross NC”) and Mission Health have entered into an agreement for Mission Health provider participation in Blue Cross NC networks effective December 15, 2017.  Both parties are pleased to reach agreement on the mutual goal of ensuring that the people of Western North Carolina receive the […]

Your Top ACA Open Enrollment Questions Answered

Open Enrollment is upon us (Nov. 1 to Dec. 15) and many customers are asking questions on social media and at our call center about their new ACA rates and changes.  Keep these in mind when reviewing your 2018 premium rates and while deciding what health plan is right for you. If you still have […]

What you need to know about Grandfathered Plans

In August we informed customers that we planned to eliminate Grandfathered Plans. We also recently sent out letters to these customers, and they are rightfully feeling a sense of “sticker shock” when seeing the new premiums for 2018. We understand they are frustrated because these insurance plans are discontinued, and premiums are going up. Grandfathered plan […]

Early Breast Cancer Detection Saves Lives

Women are masters of multi-tasking. Often a busy lifestyle and responsibilities cause them to put their health on the back-burner. Family and work come first. They juggle work calls while in the carpool line. Then homework and dinner. Their calendars may be full of errands, meetings, and extracurricular events. It’s a time to remind women […]

Believe It or Not, Abuse-Deterrent Opioids Aren’t the Answer

All of us are likely familiar with the seriousness of opioid abuse in the United States today. Since the turn of the century, more than 11,000 Americans have died every year from overdoses of prescription pain pills – and many more struggle with the destructiveness that opioid dependence can bring.   I’ve written about the […]

STOP is a Start: New NC Law Aims to Prevent Addiction, Deaths

A couple of months ago, I published a story about a former patient of mine who became addicted to prescription pain pills.  It generated a healthy discussion on social media about addiction and potential solutions to the growing problem of opioid abuse in North Carolina. Many of those suggested fixes were not only thoughtful, but […]

Mission Health System Cancels Contract With Blue Cross NC

In this time of uncertainty in the health care industry, one thing is certain: skyrocketing medical costs are squeezing North Carolina families and businesses more than ever before. That’s why we are extremely disappointed that Mission Health System (Mission Health) has chosen to cancel their contract with us rather than work toward a solution to […]

3 Millennial Health Trends Employers Need to Know

You may have read a lot about millennials, also called Generation Y, on our blog recently. Born between 1981 and 1997, millennials are a big group. As a generation, they face a different set of health care issues than the generations before them. And so will their employers. Why do these changing health care trends […]

Many Drug Prices Are Sky High. A New Law Would Send Them Higher.

Would you pay $17 for a gallon of milk? You would have to if the cost of milk had increased 500 percent in the last 15 years. Unfortunately, that’s how fast costs for oral chemotherapy drugs are rising – from approximately $2,000 a month to $10,000 a month. Meanwhile, IV chemotherapy drug prices increased at […]

Premiums to Rise in 2018 for Affordable Care Act Plans

Two weeks ago our CEO, Brad Wilson, wrote about the future of the Affordable Care Act (ACA) and what it means for individual premiums in 2018. Today we’re following up by announcing the proposed rates we’ve filed for ACA coverage next year in all 100 North Carolina counties. Our ACA customers will receive an average […]

The Future of the Affordable Care Act is Certainly Uncertain

Uncertainty over the future of the Affordable Care Act is not helping health insurers prepare to offer ACA coverage next year. It also is not helping the more than 500,000 North Carolinians who depend on the ACA for access to health care. At Blue Cross NC our actuaries are working hard to propose plans and […]

“I’ve Been Lying to You”: A Physician Learns Her Patient Has a Drug Problem

After being a patient of mine for nearly a year, an elderly woman came into my office for a follow-up visit. She had been what we physicians would consider a “good patient”: never canceled appointments, never asked for early prescription refills, never claimed she’d lost a prescription and needed a new one. Always well dressed […]

Consumers Deserve Transparency and Value in Health Care

We live in an age when we can buy groceries from our living room and have them delivered in two hours. We can lie on the beach and read about which cars have the fewest breakdowns. We can even watch an instructional video on golfing while we’re golfing. As consumers, we can compare the prices […]

You’re Paying for High-Cost Drugs, Even If You’re Not the One Taking Them

If you’ve been reading the news lately, you’ve probably heard about specialty drugs. And more often than not, the news coverage is about how much those drugs cost. What’s the big deal about specialty drugs? If you’re not taking one, do you have to care about how much they cost? Unfortunately, yes, you do. We […]

A Proposed Law Would Mean Higher Drug Prices for NC

If you’re reading this – if you’ve been conscious and alert for the past several decades – you already know that health care costs are out of control. You feel it every time you see a doctor. Every time you pick up a prescription. Every time you interact with our nation’s health care system. It […]

How We Grew Stronger for Our Customers in 2016

The time of year has come when many of us are crunching numbers, reviewing our finances and prepping our taxes. It’s no different here at Blue Cross. We have just wrapped up preparing and filing our yearly financial results. Now is good time to pause to reflect on how we have delivered on our promises […]

3 More Major Myths about the Affordable Care Act in North Carolina

Our last blog post addressing some common misconceptions about the Affordable Care Act (ACA) – commonly known as Obamacare – drew a big response from readers. But don’t worry. There are plenty more myths about the law and they’re ripe for busting. Here are a few more common misconceptions shared about the law on the BCBSNC Facebook […]

3 Affordable Care Act Myths That Refuse to Die

In this era of “fake news” and opinions that are stated with convincing certainty, you may find it hard to know what’s real. Especially when it comes to something as complex as health care. The thin line between myth and reality seems to get a lot thinner when it comes to the Affordable Care Act (ACA), also […]

Wearables and Health Care Costs: Are they related?

In 2014, BCBSNC gave 3,500 free or discounted Fitbits to its employees who wanted to take part in its company wellness programs. While participants didn’t see changes in their body mass indexes (BMI) overall, they did see results in monthly healthcare cost savings. How much? Team members that signed up for the company’s Fitbit challenges […]

Why Does Insulin Cost So Much After 95 Years?

In December 2016, Eli Lilly & Co. announced a discount program effective in 2017 for people who pay largely out-of-pocket for the company’s insulin products. Check with your insurer to see if you qualify for the discount.   Why Does Insulin Cost So Much? According to one recent study, the cost of insulin tripled in […]

5 Myths About the EpiPen Price Hike

You’ve probably heard some of the recent conversation about the steep price hikes for the EpiPen, an injection device that delivers epinephrine. Epinephrine is a life-saving hormone given to people suffering severe allergic reactions. Health care experts and news media have tried in recent weeks to explain why the cost of the EpiPen has climbed […]

We’ve Got an Eye on These Expensive Specialty Drugs

Of all the things driving medical costs higher, none gets attention quite like specialty drugs. With prices increasing to the tune of 17 percent to 31 percent a year, it’s not a surprise that these drugs are under intense scrutiny. Specialty drugs – those that are used to treat complex conditions or reach a limited […]

Narrow Networks Are Becoming the Norm, and That’s OK

From cutting the cable cord to buying “tiny homes,” consumers today are taking a hard look at the value of their purchases. This trend toward value has come to health care in some big ways, too. Narrow network plans are a viable alternative to plans with broader networks that usually come with a heftier price […]

What Will It Take to Improve the Affordable Care Act?

Blue Cross CEO Brad Wilson has a prescription for making the Affordable Care Act sustainable. He shared his thoughts on putting “affordable” in the ACA in this opinion piece in The News & Observer of Raleigh. “Simply put, the ACA is not financially sustainable without changes in the way the law is administered,” he wrote. He urged […]

Do Generics Always Save You Money? It’s Complicated.

There was a time when generic drugs were the tried-and-true way to save money on prescriptions. While that’s still true in the vast majority of cases, some notable exceptions mean that it’s time to revisit the age-old advice to always ask for generics. Pharmaceutical companies take a number of steps to boost revenue before the […]

Individual Rates Will Rise to Offset ACA Costs

If you buy your own individual health insurance through the Affordable Care Act, we have news on what to expect next year. In 2017, your insurance premiums will be going up, but not as much as in previous years. Today, we’re announcing that our filing with state and federal regulators calls for an average 18.8 […]

Our Return to Profitability and What’s to Come

Blue Cross and Blue Shield of North Carolina returned to profitability in 2015. Our financial health improved from 2014, despite the steeper losses we incurred on our Affordable Care Act (ACA) line of business. For us, and for most other insurers, the story continues to be how the ACA is posing serious challenges for our […]

Is Health Insurance a Priority in the Gig Economy?

Working as a freelancer or contractor is a good option for millions of Americans who can do without corporate bureaucracy, office politics and the ever-present threat of being laid off. If the so-called “gig economy” is how you earn a living, you might also think you can do without health insurance. But that could be […]

What Happens When a Hospital Gets Too Expensive?

As a company who has served North Carolina for as long as we have, we don’t take it lightly when ending a relationship. We recently made a difficult decision to end our contract with Carteret Health Care, a community hospital in Eastern N.C. After three years of attempting to reach an agreement with the hospital […]

8 Health Insurance Myths You Might Have Heard

Health insurance. It’s on the minds of Americans now more than ever, especially since health insurers began implementing the Affordable Care Act (ACA), also known as Obamacare, in 2013. The ACA, and all of the changes that came along with it, have made health insurance more confusing than ever before. And that has people talking. […]

What Insurers Must Do to Accelerate Health Care Reform Now

The first car I ever bought was a 1976 Chevrolet Monte Carlo. I cannot recall exactly what I paid for it, but it was a fraction of the average price of a new car today. Automobile prices have risen dramatically over the last several decades, yet no one seems up in arms over it. I […]

Countdown to ACA Coverage for 2016: Here’s Why Rates Are Higher

The main goal of the Affordable Care Act was to provide health insurance to more people. That has indeed happened in North Carolina, judging by a 13% decline in the state’s uninsured population between 2013 and 2014. Along the way to implementing the ACA in North Carolina, we’ve learned — and continue to learn — a […]

Out-of-Control Prescription Drug Costs: Who’s Doing What About It

The Rx Cost Debate With prescription drug spending soaring, many consumers and health care experts are wondering if any relief is in sight for the pain of rising costs. U.S. spending on prescriptions hit $379 billion last year. That was an increase of 13% in one year, which was the sharpest annual increase in at least […]

Here’s What Happens When 60,000 People Drop Their Insurance Coverage

Health insurance works by having a large pool of customers paying in. So when a fraction of that pool drops out, it’s no big deal since there are a lot of people left, correct? It turns out that it actually is a pretty big deal. In the first six months of this year, BCBSNC paid […]

Why the Affordable Care Act Didn’t Put Insurance Agents Out of Business

When the Affordable Care Act took effect, there were a host of predictions that the new law would leave no room for health insurance agents to offer their services. A column in Forbes even predicted the “mass firing” of agents. Fast forward a few years, and we find that the business of health insurance agents […]

Prescription Drug Costs Up 33% in One Year. How Is That Possible?

In a climate of sharply higher health care costs under the Affordable Care Act, one number stands out: 33 percent. That’s how much prescription drug costs under ACA coverage rose in one year, according to a review of our claims data. Prescription claims averaged $96.70 per month for each ACA customer in the first six […]

How Non-Emergency ER Visits Skyrocket Health Care Costs

It seemed like the right thing to do at the time: You’re not feeling well. It’s late. You’re worried something terrible might happen.  So you get someone to drive you to the emergency room, you wait for a few hours, and then you’re discharged. In a few days, you’re back to normal. That is, until […]

New Data Shows Where Your Health Insurance Premium Dollar Goes

Since the start of the Affordable Care Act, BCBSNC has exceeded the law’s requirements for spending on medical care for customers. That streak continues with our report for 2014. Out of every health insurance premium dollar collected across our various lines of business, we spent an average of 87.3 cents on medical care last year. […]

The Big Telemedicine Trend: More Coverage, New Innovations in NC

The Roots of Telemedicine What were you doing in November of 1997? Maybe you were at home on the family computer, using new technology to chat with your family or friends. It seemed pretty amazing, right? Also around that same time, these same advances emerged in the medical world, allowing patients and doctors to connect outside […]

The Snapshot of North Carolina’s ACA Market Isn’t Pretty

According to a common phrase, “All health care is local.” This is certainly true in North Carolina, where our market for coverage under the Affordable Care Act is experiencing a severe cost problem. New ACA customers in our state are continuing to use their health care benefits much more than expected for expensive medical services. […]

Think Insurers Are Cashing in on the ACA? Think Again.

Last week the federal government issued a report about payments to health insurers under the Affordable Care Act. Many people interpreted that report as indicating a “windfall” for insurers. In fact, the opposite is true for BCBSNC: Even when you account for the significant payments we received from the federal government, we lost more than […]

Today’s Supreme Court Decision Means Business As Usual for Obamacare

Since its inception, the Affordable Care Act (ACA), also known as Obamacare, has been a source of confusion for everyone—from consumers to health insurance companies. And everyone in between. Besides changing the way consumers buy and pay for health insurance, the law itself has faced a number of legal challenges. The latest, King v. Burwell, […]

Here Come the New Cholesterol Drugs. They Won’t Be Cheap.

More than 25 million Americans are on statin drugs to lower their cholesterol. Statins have been around for nearly three decades, are safe and effective for most patients, and retail for as little as $48 a year if you get generics.  A new class of drugs that cleared a regulatory hurdle last week also lowers […]

Can’t We Do Something to Better Coordinate Care?

There really is a solution to the age-old problem of uncoordinated health care — the kind of care that bounces you from place to place for various procedures and tests. Or leaves you wondering why your doctor never seems to know what medications you’re on. The answer is the team-based approach to care. It’s a […]

Yes, You’ll Probably Pay More for Your Health Insurance in 2016, and Here’s Why

It’s never easy to hear that the price of a product or service that you’ve come to rely on is going up dramatically. But this is the environment we find ourselves in when it comes to health care. Since the Affordable Care Act (ACA) marketplace opened for business, we’ve found that our ACA customers’ health […]

Will There Be Enough Primary Care Doctors in North Carolina?

Every so often a report comes out that forecasts a physician shortage, especially among primary care doctors. It happened again in March when the Association of American Medical Colleges warned that as many as 31,000 more primary care physicians in the United States are needed by 2025. Projections for North Carolina aren’t any rosier. By […]

2015: The Year of Health Care Cost Transparency

There’s more good news for health care consumers who want some idea what medical procedures cost — before they get the bill. Consider these recent examples: A startup called Clearhealthcosts.com is partnering with public radio stations in Philadelphia, Los Angeles and San Francisco to ask consumer to share what they’ve been billed for medical procedures. […]

Why Our 2014 Net Loss Wasn’t a Surprise

Our 2014 financial results, announced to news media today (Feb. 27) and filed with North Carolina insurance regulators, include something we haven’t seen since the late 1990s: A net loss. The $50.6 million net loss, while certainly a disappointment to the company, was not a surprise. Gerald Petkau, BCBSNC’s senior vice president and chief financial […]

One Step Closer to Solving the Health Care Cost Mystery

The Bigger Picture The launch of our new health care cost tool picked up some national attention earlier this month. Health care experts said the online tool gives the public more information for making decisions about their medical care. But the tool itself is only part of the story. The bigger picture is that the curtain is […]

The Health Care Forecast for 2015 in Three Steps

Health care accounts for almost one-fifth of the U.S. economy — or $2.8 trillion, give or take a few hundred billion. So it stands to reason that any forecast of our economy for 2015 needs to include a healthy dose of health care. Our CEO, Brad Wilson, highlighted just that fact in his Jan. 5 […]

We’re Bringing Cost Transparency to all North Carolinians

How would you feel if you were expected to buy a car, a television or even a meal, without knowing first how much it will cost you? Confused? Helpless? Frustrated? Unfortunately, that’s exactly how many of us feel when we’re faced with planning a medical test or procedure. We have no idea how much an […]

How Will the Future of Health Care Be Different from the Present?

Imagine a future where you — the health care consumer — are truly in charge of your care. Where you have the information you need to make smart decisions. And where you shop for health services the way you’d shop for a new car or hire an electrician. Is this a safe prediction for health […]

What to Know and Do About Medical Overtreatment

Have you ever wondered if every medical test or procedure is really necessary? Clearly, some aren’t. The Institute of Medicine says $210 billion is wasted each year on medical overtreatment — tests and procedures that either aren’t necessary or duplicate previous tests. Overtreatment can even happen when you do something as simple as switching doctors. […]

Progress in the March Toward Better Health Care Value

You might not know it, but the odds are increasing that your doctor or hospital is getting paid for the quality of care you receive. The world of medical payments continues to shift in favor of health care value, and away from the volume of procedures performed, the Blue Cross and Blue Shield Association says […]

Health Care Fraud: The $80 Billion Crime

In a nation that spends a few trillion dollars a year on health care, there are bound to be some who try to take advantage of the system for their own gain. After all, it’s just a drop in the bucket, right? Wrong. These fraudulent actions have a big and expensive impact. In 2013, the […]

Another Private Exchange Opens for Business in NC

Get ready for more options when it comes to choosing your annual health benefits. BCBSNC is launching its first private exchange for North Carolina employers with at least 51 employees. Beginning Sept. 1, the exchange lets employers select up to four different medical plans to offer their employees from a menu of 18 plan options. […]

The Drug That Costs $1,000 a Day — And Why You Should Care

You have to love the TV pitchman’s favorite question: “Why pay more?” But it’s no longer good for a chuckle when you find out there’s an actual answer. In the case of Sovaldi, the new hepatitis C drug, someone has to pay more — a lot more — than what the vast majority of other […]

Costly Habits: What $1.5 Trillion Looks Like

All the cheeseburgers, cigarettes and channel-surfing Americans enjoy certainly take their toll: Unhealthy lifestyles account for up to 40% of all deaths in the U.S. As if that’s not enough, think about the financial toll. Overall, treating preventable diseases caused by unhealthy habits costs $1.5 trillion annually. Yes, you read that correctly. $1.5 trillion. That’s […]

Exchanging Glances: More Employers Looking at Private Exchanges

The first cycle of enrollments on the new government-run health exchanges is over. The next open enrollment period doesn’t start until November. Which makes this “quiet” period the perfect time to take stock of what’s happening with another new mechanism for obtaining health insurance: The private exchange. Private exchanges are the emerging marketplaces offered by […]

The Building Blocks of Hospital Quality in North Carolina

If you’ve been following our blog, you’ll have noticed that collaboration is at the heart of what we do here at BCBSNC—it’s one of our core principles. But collaboration extends far beyond what we do in the workplace; it greatly inspires what we do in the community and industry. One of those prime examples is […]

What Happens When Hospitals Buy Up Physicians?

If you’re searching for evidence that health care consolidation drives up health care costs, look no farther than this month’s issue of the journal Health Affairs. Researchers at Stanford University examined what happens to rates for hospital services following hospital acquisitions of physician practices. Perhaps not surprisingly, hospital ownership of practices was associated with higher […]