BCBSNC Foundation Marks 25 Years, With Local Health Priorities Mirroring National Trends

As the Blue Cross and Blue Shield of North Carolina (BCBSNC) Foundation marks its 25th anniversary, its focus on access to care, health through food, and youth mental health reflects challenges that extend beyond state lines.

Evolving Strategies to Advance Community Health in North Carolina

Established as an independent entity by BCBSNC in 2000, the BCBSNC Foundation is a private, charitable foundation dedicated to improving the health and well-being of all North Carolinians by addressing the root causes of poor health.¹ Over the past 2 decades, it has refined its grantmaking and partnership strategies to support organizations and collaborations of all sizes statewide.

Since its launch, the Foundation has invested more than $269 million through grants, collaborations, and special initiatives. Although its mission has remained consistent, its strategies and priorities have changed in response to emerging challenges, insights gained, and the evolving work of its partners. Specifically, its efforts span policy, practice, and system-level change at both local and statewide levels, alongside building coalitions aligned around shared goals.

In an interview with The American Journal of Managed Care^® (AJMC^®), Katie Eyes, MSW, vice president of the Foundation, reflected on more than 18 years with the organization and the continued importance of connection in sustaining community-driven change.

“In terms of what we've been able to evolve to, [we have] connected our grantees to each other, to resources, to insights that come from the insurer perspective of BCBSNC, to experts in the BCBSNC building; we have that unique opportunity to contribute to those partnerships,” she said. “That ability to convene people, to connect them, I think, has been a meaningful part of our story over the last 25 years.”

Centering Community Voices to Guide Prevention-Focused Priorities

After stepping into the role of president in the Foundation’s 25th anniversary year, Colleen Briggs, MBA, reflected on its legacy in a letter while also looking ahead to the future.² She emphasized that the Foundation has long been guided by the belief that community-rooted nonprofit partners are best positioned to drive meaningful change.

Over the past 25 years, the Foundation has worked alongside more than 1700 nonprofits, clinics, and community leaders across the state’s 100 counties, unified by the vision that every North Carolinian deserves the opportunity to achieve good health. Briggs explained that the Foundation has grounded its work in local perspectives, as exemplified by visits to each county, which helped shape its priorities and strengthen its focus on the health challenges that most directly affect communities.

She noted that community listening has shaped the Foundation’s current focus areas: access to care; health through food; and youth mental health, connectedness, and resilience.

“…We are focused on some of the biggest cost drivers of long-term health care costs…” Briggs said in an interview with AJMC. "We continue to see that when we invest in prevention like this, it helps the system get less expensive; it actually drives down costs. So, the more we can invest in early intervention and preventive care, the more we can improve health outcomes and reduce costs for everyone.”

Targeting Key Drivers of Health to Advance Upstream Change

She outlined the Foundation’s focus areas in an interview with AJMC, beginning with youth mental health. In each county, the Foundation consistently heard that young people feel lost and without purpose. This was reflected in data, as 4 in 10 North Carolina high school students reported feeling sad, hopeless, or without purpose, and 1 in 5 teens have considered suicide. Yet, more than 60 counties have no child or adolescent psychiatrist, leaving families with few options.

The Foundation’s response centers on 3 pillars: expanding access to high-quality mental health services, building community supports, and strengthening prevention and early intervention. In practice, this means embedding mental health services in 2 critical access points: pediatric and school settings.

Pediatricians are often the only mental health resource available in many counties. Meanwhile, schools offer a unique advantage, as kids are 6 times more likely to accept mental health services when offered there. Briggs added that training teachers to spot early signs and connect children to support before issues escalate into crises is essential.

Access to care presents its own challenges. Persistent barriers, especially in rural North Carolina, lead to delayed care, worse outcomes, and higher costs. Briggs highlighted BCBSNC’s enterprise-wide commitment to expand access to trusted, affordable, prevention-focused care in rural and underserved communities through 3 approaches: making coverage easier and more affordable; improving and increasing care sites; and building trust so people feel comfortable engaging with the health system.

One key avenue is through community health workers, trusted professionals who help people understand health risks, prevent disease, and connect with resources that address barriers to care. The Foundation partners with the North Carolina Community Health Worker Association to expand and strengthen this workforce so they can better address chronic conditions, access, and affordability.

Health through food rounds out the Foundation’s focus areas. Diet-related chronic conditions remain a top driver of poor health in North Carolina and are projected to cost roughly $65 billion in medical expenses in the coming years. Although most conditions are preventable with healthier diets, Briggs explained that care typically starts too late.

In response, the Foundation is participating in a company-wide, upstream initiative that uses healthy food to prevent, manage, and treat diet-related chronic disease. It involves a 3-part strategy: building skills for healthy eating, integrating “food is medicine” into health care, and expanding access to healthy food.

“…if we want health care to be more affordable and effective, we have to address the conditions that are shaping someone's health, and that starts with nutrition,” she told AJMC. “Nutrition has to be a part of the solution so that we can ultimately address these pervasive issues like diet-related chronic conditions and drive down costs for everyone.”

National Trends Mirror Local Priorities

These challenges extend well beyond North Carolina. Youth mental health, for example, has been a growing concern nationwide for years. As of 2022, nearly 20% of all young people in the US aged 3 to 17 years have a mental, emotional, developmental, or behavioral disorder, and suicidal behaviors among high school students increased more than 40% in the decade before 2019.³ Mental health challenges were the leading cause of death and disability in this age group that year, with these trends exacerbated during the COVID-19 pandemic.

Recent research also found that increased social media use in early adolescence is linked to higher depressive symptoms a year later.⁴ As more young people struggle, a growing number are turning to generative artificial intelligence chatbots for emotional support.⁵ Although many find the advice helpful, the trend raises questions about trust and safety.

Regarding access to care, prior research found that only about 51% of Americans can access and afford quality health care, with that figure disproportionately lower among Black, Hispanic, and low-income individuals.⁶ About 1 in 10 people in the US lack health insurance, making them less likely to have a primary care provider and less able to afford necessary services or medications.⁷ Geographic barriers compound the problem, as many individuals live too far from providers who offer needed services. In response, HHS has implemented Healthy People 2030, an initiative aimed at helping people get timely, high-quality health care services nationwide.

Lastly, health through food is gaining momentum nationwide. The White House Conference on Hunger, Nutrition, and Health, held in September 2022, renewed attention on the topic and issued a call to action to end hunger and reduce chronic disease prevalence in the US by 2030, with a focus on integrating consistent access to diet and nutrition resources across communities and systems.⁸

Building on this, HHS developed a “food is medicine” initiative following a congressionally funded directive in fiscal year 2023, tasking the agency with creating a strategy to reduce nutrition-related chronic disease and food insecurity through research and expanded access to food-based health interventions. Earlier this year, the agency also released new dietary guidelines, encouraging the reduction of processed foods while promoting whole foods and increased protein intake.⁹

Building the Next Chapter Through Continued Collaboration

Looking ahead to the next 25 years, Eyes reflected that the first 25 taught the Foundation that lasting progress happens through collaboration. She added that stakeholders must agree that change is necessary as the current state is not working. They then must share a vision for what the future could look like, finding common ground to move forward together.

“I'm really proud of the work over the history of the Foundation, but the 25th anniversary isn't just about looking back,” Eyes said in an interview with AJMC. “It's really sort of a new opportunity for us to commit to pushing forward with some of those lessons and with urgency and purpose on our goals with others.”

Briggs told AJMC that her vision is a North Carolina where communities are healthier because health systems work better, families have the resources to avoid preventable crises, and children have the tools and support to be mentally healthy and thrive. Central to that vision is rebuilding trust so people feel seen, respected, and supported by the health system, making them more willing to seek early, preventive care.

“All this together is just a hope that our work can help North Carolina move closer to a future where everyone, regardless of where they live, has the real opportunity to be healthier and that they have confidence that the health system is designed to support their needs,” Briggs concluded. “Ultimately, what all that would mean is that North Carolina would be one of the healthiest states in the nation in a generation. That vision has guided the last 25 years, and it's the commitment that's really driving our work ahead as well.”

References

1. Our organization. BCBSNC Foundation. Last updated July 1, 2025. Accessed April 28, 2026. https://www.bcbsncfoundation.org/our-organization/
2. Briggs C. 25 years of impact. BCBSNC Foundation. Accessed April 28, 2026. https://www.bcbsncfoundation.org/anniversary/
3. 2022 National Healthcare Quality and Disparities Report. Agency for Healthcare Research and Quality (US); 2022. Accessed April 28, 2026. https://www.ncbi.nlm.nih.gov/books/NBK587182/
4. Grossi G. Increased social media use linked to rising depressive symptoms in early adolescents. AJMC. May 21, 2025. Accessed April 28, 2026. https://www.ajmc.com/view/increased-social-media-use-linked-to-rising-depressive-symptoms-in-early-adolescents
5. Steinzor P. Adolescents, young adults use AI chatbots for mental health advice. AJMC. November 7, 2025. Accessed April 28, 2026. https://www.ajmc.com/view/adolescents-young-adults-use-ai-chatbots-for-mental-health-advice
6. Schultheis L. Nearly half of Americans can’t access or afford quality health care; Black, Hispanic, and low-income households most affected. ONS Voice. May 26, 2025. Accessed April 28, 2026. https://www.ons.org/publications-research/voice/news-views/05-2025/nearly-half-americans-cant-access-or-afford-quality
7. Health care access and quality. Healthy People 2030. Accessed April 28, 2026. https://odphp.health.gov/healthypeople/objectives-and-data/browse-objectives/health-care-access-and-quality
8. Food Is Medicine: a project to unify and advance collective action. Office of Disease Prevention and Health Promotion. Accessed April 28, 2026. https://odphp.health.gov/our-work/nutrition-physical-activity/food-medicine
9. Grossi G. New HHS dietary guidelines take hard line on processed foods for first time. AJMC. January 14, 2026. Accessed April 28, 2026. https://www.ajmc.com/view/new-hhs-dietary-guidelines-take-hard-line-on-processed-foods-for-first-time