CONTACT: Jenna McPhee
BOSTON — June 30, 2009 — Blue Cross Blue Shield of Massachusetts (BCBSMA) today announced it's awarded physicians in Massachusetts an estimated $27 million for their quality and efficiency as part of the 2007 Primary Care Physician Incentive Program (PCP Incentive Program). Additionally, 636 in-network physicians ranking in the top 10% of the program have been awarded with Certificates of Excellence.
Launched in 2000, the PCP Incentive Program is a quality-based program that rewards physicians for delivering safe, effective, efficient health care services. This is the eighth consecutive year physicians have been recognized for their excellence and have also earned incentive payments above their regular fees-for-service for meeting nationally recognized measurements designed to improve quality of care. Since its inception, $164 million in payments have been awarded to participating physicians.
In 2007, adult practitioners in the program were measured on generic prescription utilization, appropriate control of elevated cholesterol levels, diabetes care, electronic technologies adoption (the implementation of an e-prescribing system, electronic medical records, or quality outcomes of reporting tied to cholesterol/diabetes management and hypertension) and completion of cultural competency training.
Pediatric practitioners were measured on body mass index (BMI) screenings, ADHD medication management, electronic technologies adoption (the implementation of an e-prescribing system, electronic medical records, or quality outcomes reporting tied BMI) and completion of cultural competency training.
"The PCP Incentive Program is consistent with our work to transform the health care system to address the underuse, overuse, and misuse of health care services to reward for the quality and outcome of care and of care our members receive," said John Fallon, MD, Chief Physician Executive at BCBSMA.
As part of BCBSMA's promise to "always put our members" health first," the insurance plan is committed to working with doctors and hospitals on initiatives that facilitate access to safe, effective, and affordable health care. In 2009, BCBSMA is making additional enhancements to the PCP Incentive Program which will enable participating physicians to earn even more under the program beginning in 2010. Details regarding the new incentive targets will be made available later this summer.
Additionally, BCBSMA's Alternative Quality Contract (AQC) provides PCPs with even higher performance-based incentives than the enhanced PCP Incentive Program. The AQC is designed to improve the quality of care members receive and cut current annual medical cost trends in half. It offers hospitals and physicians the opportunity to increase their total payment (on top of global payment) based on their performance on quality measures and improvements in the efficiency of the care delivered. This new payment method is a significant change from traditional fee-for-service contracts and gives physicians the flexibility to allocate health care resources based on what will have the greatest benefits to patient health.
Through investing more in our PCP Incentive Program and increasing the rewards available for physicians participating in BCBSMA's Alternative Quality Contracts, BCBSMA is providing incentives for PCP's during a time when there's a critical shortage, as well as continuing the work to reward for clinical quality, efficiency, and improved health outcomes rather than volume and complexity.
Blue Cross Blue Shield of Massachusetts ( http://www.bluecrossma.com ) was founded more than 70 years ago by a group of community-minded business leaders. Today, headquartered in Boston, BCBSMA provides coverage to more than 3 million members, 2.5 million in Massachusetts. BCBSMA believes in rewarding doctors and hospitals for delivering safe and effective care, and in empowering patients to take more responsibility, become educated health care consumers and become stronger partners with their doctors. Blue Cross Blue Shield of Massachusetts is an independent licensee of the Blue Cross Blue Shield Association.