Model With Incentives, No Penalties, Proves Popular

A patient-centered medical home model that offers financial incentives but wields no penalties has proved popular with physicians, an insurance executive told the AAFP Board of Directors here last week.

Chet Burrell, president and CEO of CareFirst BlueCross BlueShield, described how the model has both engaged physicians and reduced expensive procedures.

Although the insurer's medical home model is strictly voluntarily, Burrell said 90 percent of the plan's 4,400 physicians around the District of Columbia, Maryland and Virginia are participating. The program, which began in 2011, covers 3.4 million individuals.

Physician groups that join the program receive a 12 percent participation fee each year regardless of performance. The initiative includes no penalties or risks for physicians, Burrell said, and it treats patient consults conducted online the same as office visits. In 2014 the average practice in the program received an additional $41,000 in revenue in addition to the participation fee, Burrell told the Board.

Burrell understands why physicians may be reluctant to enter into contracts with shared risk, which is why CareFirst's medical home does not reduce payments for average or low performance scores.