Blue cross to reward primary care with 10% more reimbursement in Michigan (NEWS)

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.

tony montana

Dr. G-Spot
10+ Year Member
15+ Year Member
Joined
May 6, 2006
Messages
269
Reaction score
1
Under the program announced, the Blues will pay primary-care doctors 10 percent more for office visits, partially compensating them for the additional time they must spend with each patient...



Blue Cross Blue Shield announces statewide program to improve patient care, cut health care costs
by Pat Shellenbarger | The Grand Rapids Press
Tuesday April 21, 2009, 6:23 PM

GRAND RAPIDS -- It is an idea its advocates say should revolutionize medical care, keep patients healthier and save health care dollars.

Blue Cross Blue Shield of Michigan announced Tuesday more than 1,000 physicians statewide will participate in a program it touts as a model of health-care reform for the rest of the nation.

The program is called the Patient-Centered Medical Home, which emphasizes a stronger relationship between the patient and primary-care doctor backed by a team of nurses, dietitians and others.
Jeff Connolly

"All our efforts are around strengthening the doctor-patient relationship," said Jeff Connolly, president of Blue Cross Blue Shield's West Michigan operations, adding it "will ultimately change the way we provide medical care in West Michigan."

Touting it as the largest medical home program in the nation, Connolly said: "We believe this work will provide a national benchmark" for health care reform.

The Blues and several West Michigan physician groups have been refining details of how the patient-centered medical home will work since 2004. Two of West Michigan's largest physician groups -- Advantage Health Physician Network and Michigan Medical P.C. MMPC -- are among those participating in the program.

The program relies on primary-care doctors -- including family physicians, pediatricians and internists -- to coordinate their patients' care, avoiding duplication of tests and unnecessary referrals to specialists.

The current insurance system tends to pay more for specialty care rather than prevention, which contributes to a looming shortage of primary-care doctors. If primary-care doctors can keep patients healthy, particularly those with chronic illnesses such as diabetes, they can avoid more expensive procedures, advocates said.

Under the program announced, the Blues will pay primary-care doctors 10 percent more for office visits, partially compensating them for the additional time they must spend with each patient, said Dr. Thomas Ruane, medical director for the Blues' PPO and care management programs.

The medical home requires doctors to offer more convenient office hours, including early mornings, nights and weekends, said Dr. David Blair, president of Advantage Health.

Using computerized medical records, physicians and their staffs will monitor patients care, contacting them when its time to come in for periodic appointments, he said. Prescriptions will be transmitted electronically, minimizing mistakes, and patients will be reminded to take their medications.

"We have to move in this direction," said Lody Zwarensteyn, president of the Alliance for Health, the area's health-planning agency. "Health care, as it's delivered in the United States, is not sustainable."

Not all doctors are quick to embrace the medical home, said Dr. Mary Ellen Benzik, medical director for Battle Creek-based Integrated Health Partners.

She compared it to "trying to change the engine on an airplane when it's flying at 10,000 feet."

"Your physician is going to guide your care, and they'll have the right tools to guide your care," she said. "This is how health care is supposed to be."

E-mail Pat Shellenbarger: [email protected]



http://www.mlive.com/news/grand-rapids/index.ssf/2009/04/blue_cross_blue_shield_announc.html

Members don't see this ad.
 
The only part I dislike is that whole business about having to work weekends...

I wonder if that's mandatory...
 
I think they are just trying to preempt an even larger mandated pay increase and the stipulation for working weekends is total BS. I mean come on 10 percent isn't even 20,000 dollars.
 
Members don't see this ad :)
The only part I dislike is that whole business about having to work weekends...

I wouldn't have any objections to working weekends, nights, or even holidays, provided you could charge extra for it. I mean, seriously...plumbers do it. Why can't doctors?

Incidentally, I would *NEVER* (I think I ran out of ways to emphasize that) sign any insurance contract that told me what kind of hours I had to keep.
 
I wouldn't have any objections to working weekends, nights, or even holidays, provided you could charge extra for it. I mean, seriously...plumbers do it. Why can't doctors?

Incidentally, I would *NEVER* (I think I ran out of ways to emphasize that) sign any insurance contract that told me what kind of hours I had to keep.

every time that I turn around, increasing compensation to Primary Care -- this is a weekly topic now -- finally... I do not think that they have a choice at this point....
The system would shut down, if they decided to take more money away from Primary Care.
Nobody tells me, or anybody in my group what hours to work.. as a matter of fact we choose what days and hours we want to work.. :cool:
 
Top