CareFirst BlueCross BlueShield Announces First-Year Patient-Centered Medical Home Results
CareFirst BlueCross BlueShield (CareFirst) today announced that nearly 60 percent of eligible primary care Panels (small groupings/teams of primary care physicians and nurse practitioners) earned increased reimbursements for their 2011 performance in CareFirst's Patient-Centered Medical (PCMH) program. Increased reimbursements - or Outcome Incentive Awards (OIAs) - are based on a combination of savings achieved by a particular Panel against projected 2011 total care costs for CareFirst members as well as the attainment of quality points in the provision of care to Panel patients. OIAs will be paid to PCMH participants in the form of increased fee reimbursements for certain primary care services beginning July 1, 2012 and continuing through June 30, 2013.
Highlights of the first-year of the PCMH program include:
- Program participants (Panels) earning OIAs achieved an average 4.2 percent savings against expected 2011 care costs.
- Program participants who did not earn OIAs registered costs that averaged 4 percent higher than expected for 2011.
- On average, participants earning OIAs will see an increase in their reimbursement level of 20 percentage points. This increase is in addition to a 12 percentage point increase paid to all participants that continue to remain in good standing in the PCMH program.
- The cost of care for all CareFirst members attributed to PCMH participants was 1.5 percent lower than had been projected for 2011.
- Quality scores for panels receiving an OIA and those not receiving an OIA were comparable.
