Aetna to pay medical home docs extra monthly per-patient fee

On the heels of WellPoint's new primary care physician reimbursement initiative, Aetna announced it's launching a new payment program that offers primary care physicians a financial incentive to better coordinate and manage patients' overall health.

Aetna on Monday said it will give doctors participating in a qualified patient-centered medical home (PCMH) an extra monthly payment, amounting to an additional $2 to $3 per member per month, the Associated Press reported.

"Our PCMH program rewards primary-care physicians who focus on the patient's entire health needs, not just a single condition," said Elizabeth Curran, head of Aetna's national network programs. "As a result, members may experience better health, fewer hospitalizations, improvements in transitions of care, and greater engagement. The PCMH program is one more way we are moving from a system that rewards the quantity of procedures to a system that rewards quality outcomes."

The new initiative allows Aetna to reward primary care physicians without dramatically changing the entire payment system, according to the Hartford Courant.

Aetna plans to first roll out the program in Connecticut and New Jersey, where new payments will add about 15 percent to doctors' reimbursement fees for non-Medicare patients. The insurer plans to take the program national later this year, reported The Wall Street Journal.

Although it didn't provide specific estimates, Aetna said it could save double the cost of the new PCMH bonus program. So far, 30 percent of Aetna's in-network primary care doctors already are eligible for the bonuses, and the insurer expects that number to rapidly grow, WSJ noted.

To learn more:
- read the Wall Street Journal article
- check out the Associated Press article
- read the Hartford Courant article

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