Blue Cross Blue Shield of Michigan has announced a plan to increase by 10 percent reimbursement rates for physicians participating in “patient-centered medical homes.”
In order to qualify for the raise, physicians will be required to utilize electronic health records; emphasize chronic disease management care through cooperative work with dieticians, nurses, and health care coaches; and work to prevent their patients from making emergency room visits deemed “unnecessary” by Blue Cross Blue Shield (BCBS) administrators.
“I’m all in favor of good doctors earning more money than their less-effective peers, but I am leery that an insurance company should be doing the ranking,” said John R. Graham, director of health care studies at the Pacific Research Institute.
“The Patient-Centered Medical Home is promoted as a cure-all these days,” Graham continued, “but I wonder if it’s just a way to insert another billing code into the system without using the terms managed care or capitation. Time will tell.”
BCBS spends $4 million each year collecting data from Michigan hospitals to guide its health care recommendations, according to a company release.
In March BCBS of Michigan implemented a rate hike on policyholders, raising insurance premiums by 55 percent on some individual plans and 42 percent on some group plans. The move affected about 400,000 Michigan residents, according to State Attorney General Mike Cox, who has requested a hearing regarding the increases.
Nothing contained in this blog is to be construed as necessarily reflecting the views of the Pacific Research Institute or as an attempt to thwart or aid the passage of any legislation.
Blue Cross Blue Shield of Michigan Pushes Medical Homes
Krystle Russin
Blue Cross Blue Shield of Michigan has announced a plan to increase by 10 percent reimbursement rates for physicians participating in “patient-centered medical homes.”
In order to qualify for the raise, physicians will be required to utilize electronic health records; emphasize chronic disease management care through cooperative work with dieticians, nurses, and health care coaches; and work to prevent their patients from making emergency room visits deemed “unnecessary” by Blue Cross Blue Shield (BCBS) administrators.
“I’m all in favor of good doctors earning more money than their less-effective peers, but I am leery that an insurance company should be doing the ranking,” said John R. Graham, director of health care studies at the Pacific Research Institute.
“The Patient-Centered Medical Home is promoted as a cure-all these days,” Graham continued, “but I wonder if it’s just a way to insert another billing code into the system without using the terms managed care or capitation. Time will tell.”
BCBS spends $4 million each year collecting data from Michigan hospitals to guide its health care recommendations, according to a company release.
In March BCBS of Michigan implemented a rate hike on policyholders, raising insurance premiums by 55 percent on some individual plans and 42 percent on some group plans. The move affected about 400,000 Michigan residents, according to State Attorney General Mike Cox, who has requested a hearing regarding the increases.
Krystle Russin ([email protected]) writes from Texas.
Nothing contained in this blog is to be construed as necessarily reflecting the views of the Pacific Research Institute or as an attempt to thwart or aid the passage of any legislation.