Philadelphia's Independence Blue Cross is replacing its old pay-for-performance program with a new reimbursement model that includes bigger incentive payments to healthcare providers who improve quality while also reducing costs, according to a Courier-Times news report.
Independent Blue Cross' older reimbursement model only incentivized healthcare providers who improved the quality of their care. Their new Integrated Provider Performance Incentive Program now also includes a focus on reducing costs. Although healthcare providers are not required to participate in the program, those who do may see incentives up to seven or eight figures annually. The new program also allows medical specialists to participate.
The incentive program calls for the payor to contract with a joint provider organization, comprised of a hospital and physicians. Independence Blue Cross will work with hospitals to develop goals for healthcare costs based on the hospital's medical cost history. Simultaneously, goals would be established for reduction in readmissions for the same condition, reductions in hospital-acquired infections and the use of evidence-based treatment for conditions including heart attack and pneumonia.
"Safe guards" are also put in place to ensure providers don't favor cost-reduction goals over quality goals. If a joint provider organization demonstrates lower costs but does not meet quality goals, they will not be able to share a greater incentive. Measurement periods for the incentive program will begin early next year, according to the news report.
Read the news report about Independence Blue Cross.
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Independent Blue Cross' older reimbursement model only incentivized healthcare providers who improved the quality of their care. Their new Integrated Provider Performance Incentive Program now also includes a focus on reducing costs. Although healthcare providers are not required to participate in the program, those who do may see incentives up to seven or eight figures annually. The new program also allows medical specialists to participate.
The incentive program calls for the payor to contract with a joint provider organization, comprised of a hospital and physicians. Independence Blue Cross will work with hospitals to develop goals for healthcare costs based on the hospital's medical cost history. Simultaneously, goals would be established for reduction in readmissions for the same condition, reductions in hospital-acquired infections and the use of evidence-based treatment for conditions including heart attack and pneumonia.
"Safe guards" are also put in place to ensure providers don't favor cost-reduction goals over quality goals. If a joint provider organization demonstrates lower costs but does not meet quality goals, they will not be able to share a greater incentive. Measurement periods for the incentive program will begin early next year, according to the news report.
Read the news report about Independence Blue Cross.
Related Articles on Reimbursements:
Judge Allows Antitrust Suit Against BCBS Michigan to Proceed
South Carolina to Reduce Medicaid Payments to Some Hospitals, Physicians
New Hampshire Budget Includes $250M in Cuts to Hospitals