WellPoint has launched a new reimbursement initiative that pays more money to primary care doctors who meet certain quality goals when they keep patients healthier and lower costs. The program will increase doctors' revenue opportunities, enhance information sharing and provide care management support, WellPoint said Friday.
Under its new approach, WellPoint will spend $1 billion or more to increase primary care doctors' fees by roughly 10 percent, but it could potentially increase doctors' total fees by 50 percent, reported The Wall Street Journal. WellPoint also will pay doctors for certain services, including developing treatment plans for patients with chronic diseases that aren't currently reimbursed.
One goal for WellPoint's primary care investment, which would increase its overall medical spending by 1 percent, is to save money in the long-term by improving overall patient health and reducing expensive medical services, including emergency room visits and hospital stays. The insurer estimates the new payment approach could result in a 20 percent reduction in projected medical costs by 2015.
WellPoint also said it wants to give doctors a chance to do more for patients outside of episodic care so they can better understand their overall health, which could eventually help prevent chronic conditions, reported the Associated Press.
It also hopes the payment change will help attract new members. "By being the best at promoting improved health status and reduced cost, our membership base will grow and we will be the preferred plan not only to individuals in the exchanges and employers but to the primary care physicians," said Jill Hummel, WellPoint's vice president of payment innovation, told Bloomberg. "We're investing in primary care but aggregate costs will go down."
WellPoint with its network of roughly 100,000 primary-care doctors could potentially see a wide-reaching impact from its new payment methods. The "scale is so much bolder than things we've seen," Paul Ginsburg, president of the Center for Studying Health System Change, told WSJ. "This isn't an experiment."