Blue Cross to Boost Primary Care Payments in New York, Connecticut

Tags: accountable care | Blue Cross Blue Shield | insurers | patient centered medical home | primary care physicians | reimbursement

Blue Cross Blue Shield has launched new programs in Connecticut and New York under which primary care physicians will be paid more for quality and cost improvements.

Physicians participating in the Empire Blue Cross Blue Shield program in New York can earn increased reimbursement through: a general increase to regular fees paid to physician practices for specific services; payment for "non-visit" services currently not reimbursed; and shared saving payments for quality outcomes and reduced medical costs. Physicians who maintain or improve quality can earn 30-50 percent more through this shared savings model.

Physicians participating in the Anthem Blue Cross Blue Shield program in Connecticut can receive the same types of increased reimbursement as the Empire program except for the general increase. Anthem has also applied to CMS' Comprehensive Primary Care Initiative, which is planned to go into effect July 1. There will be five to seven sites participating in this program throughout the country, and it functions very similarly to a patient-centered medical home. Anthem launched a PCMH pilot in 2011.

Related Articles on Insurers and Primary Care Physicians:

Aetna Launches Patient-Centered Medical Home Program
Wellpoint Bumps Up Reimbursement for Primary Care Physicians
Cigna Launches Accountable Care Program With Weill Cornell Physicians

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