WellPoint changes will reward primary care, care management
Health insurer Wellpoint plans to increase primary-care doctor payments and start reimbursing for care management it doesn’t currently cover as a way to boost treatment and save money. The Indianapolis-based company said it will start paying for services such as preparing care plans for patients with complex medical problems. It also will offer doctors an opportunity to share in some savings when better patient care leads to a reduction in costs. Primarycare doctors say low reimbursement rates force them to cram as many patient visits as possible into a typical day in order to make enough money to stay afloat financially. The insurer said its experience with patient-centered medical home programs has led to an 18% decrease in hospital admissions and a 15% drop in total emergency-room visits in their markets. Wellpoint’s new primary-care reimbursement plan builds on what the insurer saw in those pilots and tries to reward doctors for better care management. Wellpoint operates Blue Cross and Blue Shield plans in 14 states and is the largest health insurer based on enrollment, with more than 34 million people covered. The insurer will start rolling out this new payment plan in the third quarter and aims to implement it across its primary-care network by the end of 2014.