Health insurer Highmark Inc. is making headway in improving the way primary care doctors deliver care while saving money along the way.
Highmark has been aggressively reaching out to its physician groups in Pennsylvania, West Virginia and Delaware, offering consultation and other help to change the way medicine is practiced. Highmark is encouraging primary care doctors to create the patient-centered medical home model for their practice or join Highmark’s physician incentive program called the Accountable Care Alliance, said Twyla Johnson, manager of provider partnerships.
Both programs reward doctors for reaching certain quality of care metrics and the ACA allows doctors to earn bonuses up to $27 per patient, the highest incentive offered by an insurer. The program also fosters loyalty between doctors and the insurer, even as all of a practice’s patients benefit, regardless of health insurance.
Dr. Jeffrey Minteer, director of Washington Hospital’s family medicine residency program, said the move to patient-centered care has been a boon for affiliated medical centers. Washington Health System Family Medical Centers see some 60,000 patient visits annually.
“We’ve been wildly successful,” Minteer said. “It has helped focus us.”
Highmark has enlisted 850 medical practices representing 4,000 doctors in Pennsylvania, West Virginia and Delaware, Johnson said. The penetration rate in western Pennsylvania ranges up to 70 percent, with a goal of having 75 percent of all practices enrolled by 2016.
Date: September 22, 2014