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Perspective | Building a coalition to improve access to health care – for all North Carolinians

“We cannot solve our problems with the same thinking we used when we created them.”

Albert Einstein

The message is clear and resonant: Together, we must improve access to health care for all North Carolinians. If nothing else, the pandemic has proven that it is imperative that our communities are able to quickly navigate across health care systems and services, activate a community-wide strategic plan, and use innovative approaches to work together towards a common purpose and goal. It is equally important to recognize the unique needs and differences of communities. At Blue Cross and Blue Shield of North Carolina (Blue Cross NC), we are deepening and advancing relationships throughout the state and in communities by listening and learning to achieve our purpose.  

On my arrival as president and CEO of Blue Cross NC, I set an audacious goal to visit all 100 North Carolina counties in 12 months. Blue Cross NC understands that each county and community across our great state is unique, and we are committed to hearing from leaders, educators, policymakers, and our customers across the state. While the current public health crisis delayed our in-person goal, it never stopped Blue Cross NC from continuing to listen and learn from the members and communities we proudly serve.

We’ve coined our trek the Extra Miles Tour as we meet with what I like to call our “coalition of the willing,” collaborative people, health systems and organizations who are indeed going the extra mile to improve the health of North Carolina. So far, we have visited Alamance, Guilford, Pitt, Lenoir, Buncombe, Henderson, Forsyth, Surry, Pasquotank, Currituck, Robeson, Scotland, Cumberland, Harnett, Nash, Edgecombe, and Durham counties. We are well on our way to visiting all 100 counties — we won’t stop until we reach all 100 NC counties.

I’ll note six overarching observations to date, from our Extra Miles Tour:

  1. From the mountains to the coast, North Carolina is a beautiful, diverse state,
  2. The impact of COVID-19 across North Carolina is an ongoing concern,
  3. To impact the overall health and well-being outcomes of North Carolinians, we must address the conditions that can adversely affect health, like access to nutritious foods. Blue Cross NC has efforts in flight to impact what is often described as the “drivers of health,”
  4. Access to quality, affordable health care — including behavioral health services, primary, and oral health care — remains a challenge in urban, rural, and underserved communities,
  5. North Carolina’s universities and community colleges play a critical role in stimulating economic and workforce development, serving as innovation hubs to advance key industries such as nursing and other allied health professional careers, and
  6. Broadband access is instrumental for North Carolinians to access health care in rural and underserved communities.

I am inspired by all the communities we’ve visited and the great people we’ve met. Community leaders are tackling concerns of access to health care head-on: building partnerships within and across county lines; embedding community health workers in distressed and underserved communities; creating emotional and behavioral support teams to meet community members where they work, worship, play; and so much more. The conversations we’re having on our Extra Miles Tour confirm that access to quality, affordable health care is a pressing need across North Carolina. There is so much work yet to be done, but we are seeing progress in the effort to make health care more affordable and accessible.

Conveniently accessing health care

To make care accessible, we must address costs and provide consumers with tools and technology that allow them to be more active participants in their health care.

According to the Center for Disease Control (CDC)/NC DHHS Behavioral Risk Factor Surveillance System (BRFSS) Prevalence and Trends data, of those surveyed, in the past 12 months:

  • 10% of North Carolinians needed to see a doctor but could not access a doctor due to cost.
  • 15-20% of North Carolinians could not access health care because they do not have health care coverage.

Too many North Carolinians are not receiving basic primary, dental, and mental/behavioral health care services due to zero health care professionals being available or accessible in some counties and the inability to travel to receive those services. As of January 2021, the North Carolina Department of Health and Human Services reported nearly 90% of North Carolina’s counties are identified as health professional shortage areas. This is significant and addressable. The NCIOM Healthy NC: 2030 Report provides a strong foundational blueprint. Let’s build off of these collective efforts.

Another way is by supporting patients’ choice of telehealth. There continues to be significant patient demand for primary and behavioral health telehealth services. Blue Cross NC supports patients’ choice of telehealth, when clinically appropriate, as a less costly and more convenient method of care. In 2020, telehealth usage for Blue Cross NC members increased by more than 7,500%. Removing government impediments and guarding against regulatory structures that reduce the competitive benefits of this option are imperative to the continued success and innovation in this important area. Everyone deserves access to affordable, high-quality care whether delivered in-person or virtually.

Together we can and will make it happen

North Carolina is a large, diverse state. Health needs vary from region to region, city to city, community to community. Blue Cross NC is committed to learning what more we can and should be doing. Blue Cross NC is the largest health insurer in the state, and we stand with all North Carolinians. You (collectively) are our experts. Meeting the wide range of health needs requires partnerships rooted in a common vision of better, simpler, more affordable health care accessible. This goes beyond just health care — it is mission critical that we accelerate our efforts in improving the health and well-being for all North Carolinians. These are our communities — a healthier NC is a thriving NC.

We are proud to take an active role in these partnerships and work with the “coalition of the willing,” people who share a commitment to making life better in North Carolina — for everyone. 

Dr. Tunde Sotunde

Tunde Sotunde MD, MBA, FAAP is the President and CEO of Blue Cross and Blue Shield of North Carolina (Blue Cross NC).