FARGO – Blue Cross Blue Shield of North Dakota (BCBSND) has signed Total Cost of Care contracts with Altru Health System, Grand Forks, and Sanford Health, Fargo and Sioux Falls. These new contracts are part of an effort to reimburse medical facilities with an emphasis on quality of care rather than volume of services delivered, while improving care coordination and holding down member health care costs.
BCBSND is approaching the state's six largest integrated health care systems about signing Total Cost of Care contracts. Altru and Sanford are the first of the state's largest integrated hospital systems to sign the new reimbursement arrangement. BCBSND officials are working with the state's other main hospital systems and anticipate reaching agreements with other providers.
The shift in the reimbursement model mirrors a national trend of insurance companies and medical providers adopting the principles of Accountable Care Organizations (ACOs), or a network of insurance companies, providers and doctors that collaborate to better coordinate patient care. The goal is to improve the quality of care delivered and reduce health care costs.
"This arrangement, along with our MediQHome program, will improve coordination of care, resulting in better quality care for patients and a reduction in spending by our members," said Charley Cichy, BCBSND's vice president of Provider Relations and Reimbursement. "BCBSND is excited to collaborate with Altru, Sanford and other providers to help build a sustainable health system in North Dakota that ensures our members receive the right care, at the right time, in the right place, and for the right reasons. The main goal of this agreement is to improve the quality of care delivered to our members by rewarding providers for providing quality care. We believe that improved quality will lead to reduced future health care costs."
Cichy said North Dakota's integrated health care delivery system makes the state conducive to an ACO payment model. One hundred percent of hospitals and 98 percent of doctors in North Dakota accept BCBSND insurance coverage.
The mission of BCBSND, a not-for-profit mutual insurance company that is governed by a 13-member board of directors, is to offer the best-possible health insurance coverage while providing superior value and service to its members. In 2011, 89 percent of every premium dollar collected by BCBSND was paid out in member claims. BCBSND is leading efforts to control costs and is working together with doctors, hospitals and others to help improve North Dakota's health care system. The company is proud of its history of serving North Dakotans for more than 70 years.
BCBSND is an independent licensee of the Blue Cross and Blue Shield Association.