Blue Cross and Blue Shield of Nebraska and Think Whole Person Healthcare announce new patient-focused total cost of care agreement

Delivering quality care in the most cost effective manner that improves the patient experience is the concept behind a patient-focused care reimbursement agreement between Blue Cross and Blue Shield of Nebraska (BCBSNE) and Think Whole Person Healthcare.

"We are excited to offer this option for our members,” Dr. Joann Schaefer, BCBSNE chief medical officer and senior vice president, said. “Studies have shown that the stronger a patient’s ties are to his primary care physician, the better the quality and efficiency of the care.”

Think Whole Person Healthcare is a physician-led organization that serves the Omaha metro area. It is one of the largest independent primary care practices in the United States with 25 physicians serving 48,000 patients working in a team environment that integrates pharmaceutical care, clinicians such as podiatrists, physical therapists, dentists, audiologists, optometrists and case management teams including care coordinators and managers.

Think Whole Person Healthcare CEO Fergus Hoban said: “This is why Think exists. Already in the short six months we have been open, we have seen healthcare costs for our patients drop significantly through our team-based approach. Our patients, particularly those with chronic conditions, are seeing quality care that keeps them on therapeutic goal, improves their lifestyle and lowers the cost of their care.

“For example, our pharmaceutical care teams, working with our physicians, have reviewed over 4,000 patients’ medications for effectiveness, safety and cost. In the majority of cases this has led to patients staying healthier, being more compliant and often paying less for their medications.”

“This agreement endorses that approach and demonstrates that our triple aim of keeping patients healthier, improving their experience of healthcare while lowering their costs gives true accountability to those that matter most – our patients,” Mr. Hoban added.

Under the agreement Think physicians will be transitioned from a fee-for-service model to one that holds them accountable for patient outcomes that keep patients healthy and lowers costs.

In a patient-focused care environment the care is delivered in the primary care setting, which includes services such as disease management and preventive care. The patient is surrounded by a care team including physicians, pharmacists, clinical case managers and coordinators all working collaboratively to ensure greater consistency for the patient – keeping the patient out of the hospital and improving overall health. Essentially, the model helps align incentives toward prevention and improved outcomes.





The percentage of the bill you pay after your deductible has been met.


A fixed amount you pay when you get a covered health service.

Tiered benefit plan

A health care plan featuring multiple levels of benefits based on the network status of a particular provider. 


The annual amount you pay for covered health services before your insurance begins to pay.

emergency care services

Any covered services received in a hospital emergency room setting.


Includes behavioral health treatment, counseling, and psychotherapy

in-network provider

A provider contracted by your insurance company to accept an agreed upon payment for covered services. 

OUT-OF-network provider

A term for providers that aren’t contracting with your insurance company. (Your out-of-pocket costs will tend to be more expensive if you go to an out-of-network provider.)


Your expenses for medical care that aren’t reimbursed by insurance, including deductibles, coinsurance and co-payments.


If you can afford health insurance, but choose not to buy it, you must have a health coverage exemption or pay a tax penalty on your federal income tax return.


The amount you pay to your health insurance company each month. 

Preventive services

Health care services that focus on the prevention of disease and health maintenance.


Services and devices to help you recover if you are injured or have surgery. This includes physical, occupational and speech therapy.

special enrollment period

The time after the Open Enrollment Period when you can still purchase health insurance only if you have a qualifying life event (losing other health coverage, having a baby, getting married, moving).


A physician who has a majority of his or her practice in fields other than internal or general medicine, obstetrics/gynecology, pediatrics or family practice.