Thursday, September 09, 2010

BCBS North Carolina Rewarding Physicians for Better Care, Not More Care, Through Blue Quality Physician Program

Here's one Medical Home reimbursement model that does not include capitation. Sicker patients tend to have more visits which are also reimbursed at the higher rate just as are the healthier patient visits. SV

* Program rewards eligible physicians meeting quality standards
* Open to primary care doctors who agree to BCBSNC’s standard contract
* Physicians may qualify for double-digit increases in reimbursement for commonly billed services

Participating physicians who meet a set of criteria that includes nationally recognized, evidence-based standards for quality of care are eligible for reimbursement that offers double-digit increases over BCBSNC’s standard fee schedule for some of their most commonly billed codes. BCBSNC will reimburse at a higher level once the physician is approved for the program.

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