NEWTON, Mass.--(Blue Cross and Blue Shield of North Carolina (BCBSNC), a leader in delivering innovative healthcare products and services to more than 3.6 million members, has selected McKesson to help automate its provider contracting process. BCBSNC will use McKesson Contract Manager™ to centralize and automate the entire contracting process while driving administrative cost reductions. This decision follows closely after BCBSNC’s recent agreement to license McKesson’s ClaimsXten™ advanced claims editing solution, which helps health plans accurately auto-adjudicate more claims, even in highly complex payment and medical policy environments.)--
“To effectively manage increasingly complex reimbursement models and produce accurate, timely payment, health plans need more than just the automation of paper-based processes”
“As we move toward new care delivery and reimbursement models such as accountable care organizations and patient-centered medical homes, it is critical to become even more efficient in administering our contractual relationships,” said Lisa Cade, vice president of provider networks at BCBSNC. “McKesson’s solutions enable us to increase our speed to market with new products, increase payment accuracy and efficiencies, and make it easier for our providers to do business with us. McKesson Contract Manager, in particular, will help us standardize policies and workflows that support the complex contracting requirements of new care delivery and reimbursement programs.”
BCBSNC had previously engaged Portico Systems (acquired by McKesson in 2011) business consulting services to examine a variety of touch points with its provider community, looking for ways to streamline processes and lessen the administrative burden for both parties. During this process, the two organizations zeroed in on a highly manual contracting process, identifying an opportunity to both reduce contract cycling and other inefficiencies while making the contracting process more strategic.
McKesson Contract Manager, which is used by more than 20 health plans covering more than 12 million lives, presented an ideal solution. The solution streamlines the provider contracting lifecycle, from authoring and offering through to acceptance. With the flexibility to configure myriad payment policies, including bundled, value-based and hybrid arrangements, McKesson Contract Manager creates an easy-to-use provider contracting platform for both health plans and providers. Downstream integration increases the accuracy of payments in accordance with contract terms and decreases claims leakage.
“To effectively manage increasingly complex reimbursement models and produce accurate, timely payment, health plans need more than just the automation of paper-based processes,” explained James Evans, vice president, financial and network management, McKesson Health Solutions. “The key is to create a policy-driven environment that brings payment, benefit and medical policies into alignment, then ensures their rapid and precise execution in all downstream systems. McKesson Contract Manager is part of a suite of integrated network management solutions that help plans take a giant leap toward that essential environment.”
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About Blue Cross and Blue Shield of North Carolina
Blue Cross and Blue Shield of North Carolina is a leader in delivering innovative health care products, services and information to more than 3.6 million members, including approximately 900,000 served on behalf of other Blue Plans. For 78 years, the company has served its patients by offering health insurance at a competitive price and has served the people of North Carolina through support of community organizations, programs and events that promote good health. Blue Cross and Blue Shield of North Carolina was named one of the World’s Most Ethical Companies by Ethisphere Institute in 2012. Blue Cross and Blue Shield of North Carolina is an independent licensee of the Blue Cross and Blue Shield Association. Visit BCBSNC online at www.bcbsnc.com.
McKesson Corporation, currently ranked 14th on the FORTUNE 500, is a healthcare services and information technology company dedicated to making the business of healthcare run better. We partner with payers, hospitals, physician offices, pharmacies, pharmaceutical companies and others across the spectrum of care to build healthier organizations that deliver better care to patients in every setting. McKesson helps its customers improve their financial, operational, and clinical performance with solutions that include pharmaceutical and medical-surgical supply management, healthcare information technology, and business and clinical services. For more information, visit us at www.mckesson.com.
Tags: McKesson, ClaimsXten, Blue Cross and Blue Shield of North Carolina, BCBSNC, contract management, provider contracting, reimbursement reform, claims processing, Portico Systems