The company is hoping that the fee increase, which will typically be around 10%, will result in more regular patient visits to their family doctors’ offices, eventually lowering the number of expensive emergency and inpatient hospital visits.
Primary care doctors who qualify for the program (by meeting certain quality and patient access standards) will be eligible for additional bonuses if they successfully lower the cost of care for high-risk patients through means such as creating treatment plans for those with chronic diseases.
The move by WellPoint could influence more medical students to pursue general practice licenses, an area that is growing in need as medical specialist degrees provide for higher-paying jobs. It could also boost patient confidence in primary care doctors by increasing the amount of time they are able to spend with a physician during an appointment, as well as increasing the ease with which they can make an appointment.
WellPoint’s new reimbursement program builds on promising results found during pilot programs that established patient-centered medical homes (PCMHs) in previous years. Some of its PCMHs were attributed with decreases of 15% or more in ER visits and hospital inpatient admissions.
This morning’s Wall Street Journal article points out that several other insurers — including another top provider, Aetna — have launched similar efforts. With luck, over time this encouragement of primary care services will benefit patients and the US health system at large.