Point of View

Control high costs

New health care to-do list:

July 23, 2010 

The time for debating the pros and cons of health care reform legislation has passed. While Blue Cross and Blue Shield of North Carolina supports most of the new law, the biggest health care challenge all North Carolinians will continue to face is the rising cost of medical care, which reform legislation did not substantially address.

Health care reform cannot succeed if underlying medical costs continue to skyrocket; it will threaten our access to affordable health insurance coverage and ultimately to medical care itself.

No single segment of our health care system - insurer, employer, doctor, hospital, pharmaceutical company - can stem these rising costs alone, but working together we can make real progress toward affordable, quality care. In fact, reform creates a new window of opportunity for all these groups to join forces in new ways.

Motivated by today's business realities and the impending effect of health care reform, these efforts are under way nationwide. Large employers in North Carolina and across the country are demanding that insurers direct care to those providers who produce the best outcomes at the lowest cost, even if that requires their employees travel to get that care. And some hospitals are exploring innovative ways to improve quality and hold down costs.

Look at the Cleveland Clinic, which has become one of the most efficient hospitals in the country. Instead of doctors' getting paid for every procedure or test they perform, they're on a salary. The savings there are so significant that Lowe's home improvement stores are covering 100 percent of the cost of certain heart surgeries if their employees travel at company expense to the Cleveland Clinic.

Blue Cross and Blue Shield of North Carolina (BCBSNC) is already collaborating with doctors and hospitals to improve quality and control costs, which benefits our customers by helping to keep them healthy and holding down the rise in premiums. For example, we are beginning to restructure how we pay hospitals and doctors to encourage higher quality and more cost-efficient care. We pay family doctors more for meeting national quality standards.

Additionally, many hospitals in the state are working to meet tough national standards in common treatments and surgeries, and in return we recognize those hospitals and recommend them to our customers. We're also collaborating with our employer customers to design insurance plans that give them more transparency into the true cost of their care, so they can become partners in making health care decisions based on cost and quality.

As health care reform opens up access to coverage to more Americans, there will be a greater demand for family physicians. A key to controlling medical costs is to ensure that North Carolina has an adequate number of primary care doctors. To that end, the independent Blue Cross and Blue Shield Foundation recently made a grant of $1.18 million to the N.C. Academy of Family Physicians Foundation to help attract and train more family physicians for our state.

In my travels across North Carolina, I hear from employers and consumers every week who ask the same question: How can we get health care costs under control? As I've suggested, there are no easy answers. In fact, almost every step requires us to change how we've done things in the past. We really do have the best opportunity we've had a in a generation to take innovative steps to control health care costs. Let's not allow this opportunity to pass us by.

Brad Wilson is president and CEO of Blue Cross and Blue Shield of North Carolina and chairman of Blue Cross and Blue Shield of North Carolina Foundation.

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