Patient-Centered Medical Home Program Shows Promising Quality Trends and Continued Savings on Expected Costs
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Beyond the encouraging overall medical care spending trends,
Key quality indicators suggest positive impacts on
- 6.4% fewer hospital admissions*
- 11.1% fewer days in the hospital*
- 8.1% fewer hospital readmissions for all causes*
- 11.3% fewer outpatient health facility visits*
*Per 1,000 CareFirst Members
"Increasingly, the data we are seeing on quality and cost for the physicians participating in our PCMH program and our members under their care give us confidence that our program is taking hold and headed in the right direction," said
Currently, more than 4,000 primary care providers (primary care physicians and nurse practitioners) participate in
Approximately 69 percent of participating Panels in 2013 earned OIAs, which are paid in the form of increased reimbursements during 2014 and 2015 for their 2013 performance in the program. This is up from 66 percent in 2012 and 60 percent in 2011. On average, Panels that earned an OIA in 2013 will receive an almost 36 percentage point increase on primary care fees paid by CareFirst. This increase is in addition to the 12 percentage point participation fee paid to PCMH Providers. For a PCMH PCP earning an average award in 2013, this translates into
"What is impressive to us is that the awards have steadily increased despite a slowing in the rise of health care costs," said Burrell. "This suggests that there is ample room for improving outcomes for our members on a sustained basis, which we are greatly encouraged by."
About CareFirst BlueCross BlueShield
In its 76th year of service,
To learn more about CareFirst BlueCross BlueShield, visit:
SOURCE CareFirst BlueCross BlueShield
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