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New Insurance Exchange Plan Preserves Patient Access to Duke Health

Published August 9, 2018 | Updated September 25, 2018

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DURHAM, N.C. — Approximately 40,000 patients impacted by Blue Cross Blue Shield of North Carolina’s (Blue Cross NC) decision last week to discontinue the Blue Local exchange plan can continue to receive care from their Duke Health and WakeMed doctors in 2019 through a new health care exchange insurance plan known as Ambetter of North Carolina. Ambetter is provided by Centene, a leading provider of exchange plans in the U.S.

The new plan allows these patients to stay with Duke and WakeMed providers and care teams after Blue Cross NC eliminated Blue Local as an exchange plan option in 2019 and replaced it with a plan that does not include coverage of Duke and WakeMed providers and facilities.

In addition, the new plan makes available to all residents of Durham and Wake counties who purchase health coverage through the insurance exchange an option to choose a plan that includes coverage of WakeMed and Duke systems and access to the high-quality breadth of services that only Duke and WakeMed can provide.
Ambetter will be the only exchange plan available that offers in-network benefits for both Duke and WakeMed systems. It offers more options, more convenience and diverse levels of health care service to its plan members, from prevention, primary care and pregnancy to sophisticated medical and surgical specialties – and all close to home for those in Wake and Durham counties and surrounding areas. 

“WakeMed is committed to providing exceptional quality care at a great value right here in Wake County,” said Donald Gintzig, president and CEO, WakeMed Health & Hospitals. “We feel strongly that no one should have to leave Wake County to receive world-class care, and patients and families deserve to have access to the health care partners they know and trust. This partnership accomplishes that goal and allows us to maintain our focus on improving the health and well-being of our community.”

“We are very pleased that Ambetter will provide an exchange plan in Durham and Wake counties in 2019 that will allow our exchange patients to maintain uninterrupted continuity of care with their Duke providers,” said Thomas Owens, MD, president of Duke University Hospital and Senior Vice President, Duke University Health System. “It also provides a plan option for new exchange patients in these counties that offers the flexibility and high quality of both the Duke Health and WakeMed networks of physicians, facilities and convenient locations.”

WakeMed, the leading provider of health services in Wake County, is home to the County’s only dedicated Children’s Emergency Department and Children’s Hospital as well as the only Level I Trauma Center and inpatient Rehabilitation Hospital. More than 7,500 babies are born at WakeMed’s three hospitals each year – the most in Wake County – and its Level IV neonatal intensive care unit (NICU) offers the highest level of care available to premature and critically ill babies. Additionally, the WakeMed Physician Practices network includes approximately 300 board-certified physicians and nearly 70 convenient office locations covering more than 25 clinical specialties.

Duke University Health System is comprised of more than 2,000 physicians and a broad network of inpatient and outpatient locations and facilities throughout Durham and Wake Counties. Duke’s hospital network includes the nationally renowned Duke University Hospital, Duke Regional Hospital, Duke Raleigh Hospital and Duke Children’s Hospital. Duke Primary Care is the largest primary care network in the greater RTP area and is comprised of approximately 250 physicians and providers, with 14 offices in Wake County including a new office opening soon in Heritage, 7 in Durham, and another 9 in surrounding counties.  Duke Urgent Care locations include 5 in Durham and 1 in Wake County.  In addition, there are more than 70 specialty and primary care clinic locations in the 10-county area operated by Duke’s Private Diagnostic Clinic physicians.

Ambetter of North Carolina is pleased to have reached an agreement with both Duke and WakeMed to provide care to our members in the North Carolina exchange market in 2019. We look forward to offering competitively-priced options for quality healthcare,” said Brent Layton, Executive Vice President, Chief Business Development Officer, for Centene. “These partnerships ensure Marketplace enrollees in Wake and Durham Counties have access to leading physicians and healthcare systems.”

Current Blue Local patients will continue to be covered by Blue Cross NC for services at Duke and WakeMed through December 31, 2018.

Ambetter is expected to be available during Open Enrollment for 2019, which runs from November 1, 2018 through December 15, 2018. While rates have not yet been finalized, they are expected to be competitive with the BCBSNC exchange plan and will be announced in coming weeks. Both Duke Health and WakeMed will be contacting and sharing information with our current Blue Local patients in coming weeks about how to remain with Duke and WakeMed through the Ambetter product in 2019.

Ambetter of North Carolina is a wholly owned subsidiary of Centene Corporation. Recently licensed by the North Carolina Department of Insurance with final product approval pending, Ambetter of North Carolina focuses on the individual, providing a portfolio of innovative health solutions to meet each person’s unique needs. Ambetter plans include valuable programs, educational tools and support designed to fit the needs and budget of the consumer.
 

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