BlueCross BlueShield of Alabama Primary Care Value Based Payment Program

In 2009, BlueCross BlueShield of Alabama launched a medical home pilot program, which aimed to positively enhance the delivery and quality of patient care, improve patient engagement in their own care,  result in overall improved patient outcomes  and encourage reimbursement and benefit designs that support the practice of primary care.  The pilot consisted of three phases from September 2009 to December 2011.  Fourteen physician practices were chosen and represented a large mix of populations, both urban and rural, several specialties, and different patient populations and practice sizes who utilized multiple practice management tools and technologies. All primary care physicians that met basic requirements were eligible to participate and earn reward payments. NCQA medical home recognition was included as a criteria measure for the practices and a "Medical Home Support Team" collaborated with providers throughout the process to provide ongoing technical support and encouragement to providers.  This support team consisted of clnicians, health managment professionals, provider representatives and experts in health information technology.  

After the completion of the medical home pilot program, Blue Cross Blue Shield of Alabama launched the Value Based Payment (VBP) Program in January 2011, which initially targeted the following primary care specialties: Geriatrics, Family Practice, Internal Medicine, General Practice and Pediatric Medicine. The VBP program allows practices with NCQA PCMH or Diabetes Recognition to earn points toward value-based payment within the Administrative category requirement.