Blue Cross NC and Duke Health Partner on New Health Insurance Company

Rising healthcare costs and challenges with access to care have given rise to innovations in healthcare and new partnerships. JP Morgan, Amazon, and Berkshire Hathaway have created a new healthcare venture, CareMore Health has worked with Lyft, and Apple and Aetna have teamed up.

Now, Blue Cross and Blue Shield of North Carolina (Blue Cross NC) is partnering with Duke University Health System (Duke Health) to create a new health insurance company to meet the needs of seniors. The company, Experience Health, has filed an application to offer a Medicare Advantage plan in 2020.

“Consumers want the best possible healthcare that’s simpler and more focused on their unique needs,” Patrick Conway, MD, president and chief executive officer (CEO) of Blue Cross NC, and an editorial board member of The American Journal of Managed Care^®, said in a statement. “Experience Health will offer exactly that by featuring exceptional Duke Health medical care with efficient Blue Cross NC operations. It’s another example of our desire to collaborate closely with the state’s leading health systems to improve quality, lower costs, and deliver exceptional experience.”

The plan will focus on improving health by:

• Enhancing communication and team-based care to strengthen patient—physician relationships
• Using advanced data and analytics tools to provide optimal care to patients with chronic conditions
• Improving care coordination to include clear treatment goals and plans
• Simplifying appointments, billing, and timely access to providers

Blue Cross NC will provide enrollment, billing, and claims services to Experience Health’s customers, while Duke Health will provide medical services, including population health management programs, through its providers and facilities.

“Our goal at Duke Health is always to seek innovative ways to lead in the delivery of highest-quality care to our patients, their families and loved ones,” said A. Eugene Washington, MD, chancellor for health affairs at Duke University, and president and CEO of Duke University Health System. “Experience Health represents a one-of-a-kind collaboration between Duke Health and Blue Cross NC to enhance the quality of care, the patient experience, and to bring even greater value to our patients.”

Experience Health’s MA plan will be offered in 9 North Carolina counties, subject approval by CMS. The company will be governed by 3 members each from Blue Cross NC and Duke Health, and it will be led by Mark Waggoner.

This is not the first time Blue Cross NC and Duke Health have partnered together. Duke Health has joined Blue Premier, a value-based model of care in which Blue Cross NC and participating health systems are jointly responsible for health outcomes, cost, and customer experience.