Medical home pilots will impact 20,000 Blue Cross of Illinois beneficiaries

In yet another example that medical homes are taking root, Blue Cross and Blue Shield of Illinois has launched medical home pilot programs with two Chicago-area group practices. As with other medical home projects, these physicians are being paid more to provide patients with more intense services and better coordinated care between the practice and specialists.

While the health plan has not disclosed its exact reimbursement plans, executives said that physicians with Pronger Smith Medical Care and Elmhurst Clinic will get higher payments than under traditional primary-care contracts. To qualify, these groups had to adhere to a number of national quality measures, have an electronic medical record in place and offer 24-hour access to doctors.

Elmhurst Clinic's 35 primary-care doctors will be coordinating care with about 65 specialists, and Pronger Smith's 18 PCPs will coordinate with 27 specialists. The pilot programs will impact about 20,000 of the Blue plan's beneficiaries, but if they're deemed a success, the plan will roll out medical home payments to more of its 7.2 million members.

To learn more about the program:
- read this Chicago Tribune piece

Related Articles:
Medicare funds range of state medical home pilots
Study: Medical homes boost quality, cut costs
Case study: NY pilot changes how 'medical home' is reimbursed

Post a comment