CareFirst BlueCross BlueShield Announces First-Year Patient-Centered Medical Home Results

CareFirst BlueCross BlueShield (CareFirst) today announced that nearly 60 percent of eligible primary care Panels (small groupings/teams of primary care physicians and nurse practitioners) earned increased reimbursements for their 2011 performance in CareFirst’s Patient-Centered Medical (PCMH) program. Increased reimbursements – or Outcome Incentive Awards (OIAs) – are based on a combination of savings achieved by a particular Panel against projected 2011 total care costs for CareFirst members as well as the attainment of quality points in the provision of care to Panel patients. OIAs will be paid to PCMH participants in the form of increased fee reimbursements for certain primary care services beginning July 1, 2012 and continuing through June 30, 2013.

Currently, nearly 3,600 primary care providers participate in CareFirst’s PCMH program. Approximately 150 of the 250 eligible Panels earned OIAs for the 2011 program year. To be eligible for a 2011 award, participants had to be active in the PCMH program as of July 1, 2011. The level of OIA for each Panel is based on both the level of quality and degree of savings achieved by the participants of the Panel.

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