First in Health

Program Location: 
Raleigh, NC
Payer Type: 
Other
Partner Organizations: 
Community Care of North Carolina (CCNC)
GlaxoSmithKline (GSK)
the State Health Plan of North Carolina (SHP)
KERR DRUG
SAS
Blue Cross and Blue Shield of North Carolina (BCBSNC)
Payers: 
Blue Cross Blue Shield of North Carolina
Description: 

First in Health is a public-private partnership that will enable private-sector employers to tap into a “medical home” infrastructure created for Medicaid recipients by a nonprofit organization on behalf of the State of North Carolina in the last ten years.

Since January 2012, GSK has offered a patient-centered medical home benefit to employees as part of a pilot program in North Carolina called First in Health. Together with other employers in the state, GSK is hoping to show that by coordinating medical care, they can improve the health of their employees and reduce healthcare costs. Over 3,000 of NC-based employees – more than 20 percent of those eligible – have enrolled in the program, and initial results indicate that those enrolled are taking a more active role in managing and preventing illness compared to those who are not enrolled in the program. 

 

Payment Model: 

Employees from GSK have the option of adding the First in Health benefit to their existing health benefits. GSK waives copayments for primary care doctor visits for employees choosing this option and pay participating doctors a “per member, per month” fee for each GSK employee assigned to a medical home. These resources will fund an enhanced level of care coordination including improved HIT and “high-touch” assistance from local care managers.

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