Rahul Rajkumar Profile picture
Jun 24, 2020 12 tweets 3 min read Read on X
We’re proud to launch our Accelerate to Value program today.

🚧Here’s how it works: THREAD🚧
First, independent primary care practices apply and attest to requirements – that they’ll maintain access for our @BlueCrossNC members, use telehealth, and help our members navigate through the unique health care challenges of the pandemic.
That means practices continue delivering high quality primary care like:
✅ Referring patients to public health resources like COVID-19 testing or for contact tracing
✅ Screening for behavioral health and #SUDs
✅ Delivering recommended preventative services
✅ Managing chronic diseases
✅ Supporting transitions of care
✅ Coordinating care
If they have not already done so, practices will need to join Blue Premier either with @AledadeACO or via an existing Blue Premier clinically integrated network.
Now, let’s talk about how the math works. Step 1: We’ll take the 2019 @BlueCrossNC revenue among the eligible universe of practices and compare it 2020. We estimate the shortfall year-to-date and a forecast through the end of 2020.
Step 2: Once practices apply and have been selected, we’ll begin distributing a payment for 2020 based on the shortfall multiplied by the number of @BlueCrossNC members who are attributed to your practice as defined by our visit-based plurality algorithm.
Step 3: In early 2021, we‘ll look back at the 2020 claims experience among the same group of practices and determine whether our forecast was too pessimistic or too optimistic.
If it was too pessimistic, @BlueCrossNC will update its payments and make another distribution to practices. If was too optimistic, providers will get to keep the money.
Step 4: In 2021, we will make a new estimate about the revenue shortfall for the upcoming quarter and repeat that throughout the year.
Doing the calculations in this way allows us to be responsive in how we support practices through the next two years. The #COVID19 pandemic is not under control. That’s why we knew we needed a way to make payments that could help practices smooth out this volatility.
While these steps are happening, practices will be signing up to join a Blue Premier ACO --- officially dismounting and waving goodbye to the fee-for-service treadmill (or hamster wheel)🐹👋 👋

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More from @RahulRajkumar11

Sep 30, 2020
During a pandemic there can be glimmers of light. I am proud to announce that we have brought production of #N95 masks (beginning to end) to #NC. THREAD

mediacenter.bcbsnc.com/news/made-in-n…
The #MadeinNC collaboration will produce nearly 2 million N95 respirators per year to fill the unmet need for #NC frontline health providers during #COVID19.
Since the onset of #COVID19, demand for N95 respirators and other PPE has outpaced current global manufacturing capabilities. N95s are still scarce and many health organizations confront the issue of counterfeits and price gauging, among other obstacles.
Read 8 tweets
Aug 13, 2020
🥁Drum roll please ...The 2019 results are in. Kudos to @ConeHealth, @DukeHealth-@PDCDuke
, @UNC_Health_Care, @wakehealth, and @WakeMed (WKCC), as well as @AledadeACO who share our vision for better, more affordable health care. We did it! 🎉 THREAD mediacenter.bcbsnc.com/news/blue-cros… Image
Under #BluePremier in 2019, @BlueCrossNC’s value-based care program, providers across 5 health systems & practices affiliated w/ @AledadeACO served 536,000 members.
These health care providers also generated an estimated $153 million through cost savings, quality improvements and slowing the rate of spending on health care. 👏👏
Read 14 tweets
Aug 6, 2020
Important piece in @nytimes summarizing the promise and challenges ahead for #telehealth by @ReedAbelson. Privileged to join the conversation.

As I stated here, despite the promise, there’s a lot we don’t know about #telehealth. THREAD

nytimes.com/2020/08/03/hea…
We need to understand how it delivers value to patients by improving outcomes, quality, and affordability of care 2/
If the right hand is #telehealth, the left hand is #valuebased payment (including #PCPCapitation) - the method of how we pay matters a lot in motivating the behaviors we need to see in our delivery system. 3/
Read 17 tweets
Jul 28, 2020
📣‼️Good news – we've extended the deadline to Aug 14th for the financial support program 💰for independent primary care practices (Accelerate to Value).

We've received a lot of great questions. Here are answers to the top 6 to help make the smart decision to apply:

THREAD
Q1: How is the Accelerate to Value application connected to joining a Blue Premier ACO?

Answer: These are two *separate* applications. Accelerate to Value is a program that gives you upfront payments 💰 to stabilize practice revenue during #COVID19.
The Accelerate to Value application is due August 14th ‼️

As part of this program, you will need to join a Blue Premier ACO by December 31, 2020. It’s a separate process with that ACO. You have the next 5 months to consider your options for Blue Premier ACOs to join.
Read 11 tweets
Jul 20, 2020
📣 Today we can report #somegoodnews for sustainability of our health system. THREAD. mediacenter.bcbsnc.com/news/primary-c… Image
We are on a mission to make health care better, safer, and more affordable by transforming the health care delivery system in North Carolina.

Step 1: Change the way we pay for health care.
One of our goals is that, by 2023, every @BlueCrossNC member will have a Blue Premier provider that is accountable for their total cost of care and quality. Accountable care = better care, better experience, more efficient care.
Read 13 tweets
Jul 14, 2020
‼️ ATTN: Independent Primary Care Physicians,

If you’re in need of financial support 💰, we’ve got a program for you.

Deadline to apply is July 31. Application takes only 10 minutes - don't delay apply today. ⌛️

THREAD

bluecrossnc.com/accelerate-val… Image
The primary goal for this program is to provide upfront financial support that can help independent primary care practices weather this crisis. To do so, we will provide supplemental payments 💰 to stabilize @BlueCrossNC revenue at its pre-COVID-19 level.

3 step breakdown:
Step 1: Eligible independent primary care practices need to apply for the program by July 31. The application is non-binding and takes less than 10 minutes. bluecrossnc.com/accelerate-val…
Read 16 tweets

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