Company’s affiliated health plan markets test key investment in coordinated care
WellPoint, Inc. (NYSE: WLP) announced today that physicians working with four of its affiliated health plans have been selected to participate in a groundbreaking initiative to advance primary care and improve the accessibility and affordability of quality health care through a partnership with the Centers for Medicare & Medicaid Services (CMS).
CMS has selected 500 primary care practices in seven regions to participate in its Comprehensive Primary Care (CPC) initiative, a new partnership between payers including CMS, state Medicaid agencies, commercial health plans and self-insured businesses, and primary care providers. The partnership is designed to promote improved access to quality health care at lower costs. WellPoint is working with nearly 900 providers selected to participate in the partnership across its affiliated health plans in Colorado, Kentucky, Ohio and New York.
Through the CPC program, CMS will pay primary care practices a care management fee, initially set at an average of $20 per beneficiary per month, to support enhanced, coordinated services on behalf of Medicare fee-for-service beneficiaries. Simultaneously, participating commercial, state, and other federal insurance plans are also offering enhanced payment to primary care practices that are designed to support them in providing high-quality primary care on behalf of their members.
“WellPoint and CMS are aligned in our commitment to help improve the accessibility and affordability of quality health care for Americans, and we believe the CPC initiative represents a significant means by which we will achieve this,” said Dr. Harlan Levine, executive vice president of Comprehensive Health Solutions for WellPoint. “Primary care is the foundation of good medicine, and it should be the foundation for patient health. We are pleased that many of the physicians who participate with our health plans have been chosen for this pioneering initiative that will help improve care and reduce unnecessary costs.”
For patients, the CPC initiative means participating physicians are encouraged to offer longer and more flexible hours; use electronic health records; coordinate care with patients’ other health care providers; better engage patients and caregivers in managing their own care; and provide individualized, enhanced care for patients living with multiple chronic diseases and higher needs.
“The Comprehensive Primary Care initiative is the kind of common-sense investment in health care we need,” said Health and Human Services Secretary Kathleen Sebelius. “Businesses, families, and taxpayers all benefit from a stronger primary care system that helps to improve our health and lower costs.”
The initiative started in the fall of 2011 with CMS soliciting a diverse pool of commercial health plans, state Medicaid agencies, and self-insured businesses to work alongside Medicare to support comprehensive primary care. Public and private health plans in Arkansas, Colorado, New Jersey, Oregon, New York’s Capital District-Hudson Valley region, Ohio and Kentucky’s Cincinnati-Dayton region, and the Greater Tulsa region of Oklahoma signed letters of intent with CMS to participate in this initiative. The markets were selected in April, 2012 based on the percentage of the total population covered by payers who expressed interest in joining this partnership.
Eligible primary care practices in each market were invited to apply to participate and start delivering enhanced health care services in the fall of 2012. Through a competitive application process, primary care practices within the selected markets were chosen to participate in the Comprehensive Primary Care initiative. Practices were chosen based on their use of health information technology, ability to demonstrate recognition of advanced primary care delivery by leading clinical societies, service to patients covered by participating payers, participation in practice transformation and improvement activities, and diversity of geography, practice size, and ownership structure. CMS estimates that more than 300,000 Medicare beneficiaries will be served by over 2,000 providers through this initiative.
“Primary care practices play a vital role in our health care system and we are looking at ways to better support them in their efforts to coordinate care for their patients,” said Acting CMS Administrator Marilyn Tavenner.
The CPC initiative aligns and shares a foundation with WellPoint’s patient-centered primary care initiative to significantly strengthen the role of primary care through added financial incentives and resources. WellPoint announced its program earlier this year and has worked closely with CMS and others on the CPC effort.
The CPC initiative is a four-year initiative administered by the Center for Medicare and Medicaid Innovation (CMS Innovation Center). The CMS Innovation Center was
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At WellPoint, we believe there is an important connection between our members’ health and well-being—and the value we bring our customers and shareholders. So each day we work to improve the health of our members and their communities. And, we can make a real difference since we have approximately 34 million people in our branded health plans, and approximately 65 million people served through our subsidiaries. As an independent licensee of the Blue Cross and Blue Shield Association, WellPoint serves members as the Blue Cross licensee for California; the Blue Cross and Blue Shield licensee for Colorado, Connecticut, Georgia, Indiana, Kentucky, Maine, Missouri (excluding 30 counties in the Kansas City area), Nevada, New Hampshire, New York (as the Blue Cross Blue Shield licensee in 10 New York City metropolitan and surrounding counties and as the Blue Cross or Blue Cross Blue Shield licensee in selected upstate counties only), Ohio, Virginia (excluding the Northern Virginia suburbs of Washington, D.C.), and Wisconsin. In a majority of these service areas, WellPoint’s plans do business as Anthem Blue Cross, Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Georgia and Empire Blue Cross Blue Shield, or Empire Blue Cross (in the New York service areas). WellPoint also serves customers across the country through our UniCare subsidiary and in certain California, Arizona and Nevada markets through our CareMore subsidiary. Our 1-800 CONTACTS, Inc. subsidiary offers customers online sales of contact lenses, eyeglasses and other ocular products. Additional information about WellPoint is available at .