SOUTH PORTLAND, Maine — Anthem Blue Cross and Blue Shield in Maine has announced the launch of a new patient‐centered primary care program that at its outset includes more than 60 primary care practices in the state, providing services to more than 50,000 Anthem members.
Anthem’s program increases revenue opportunities for participating primary care physicians, enhances information sharing, and coordinates care management support between Anthem’s clinical staff and clinicians within the practice.
“Our daily mission is to provide our members with access to affordable, quality health care and this is an important step forward,” said Daniel Corcoran, president and general manager, Anthem Blue Cross and Blue Shield in Maine, in a press release. “We strongly feel that the role of the primary care physician is critical to the health and well-being of the patient and this initiative represents a major investment in the vital relationship between the doctor and the patient.”
The program will incorporate best practices from successful medical home pilots operated by Anthem and several of its affiliated health plans in other markets. “These programs have shown to have great value and our patient‐centered primary care program builds and expands upon that effort,” said Jeffrey Holmstrom, D.O., Anthem’s medical director. “We’re very excited to be able to launch this in Maine and feel it will be a great benefit to our members and provider partners.”
Dr. Holmstrom added that there are currently 345 participating physicians, who will be able to earn additional revenue through payment for “non‐visit” services currently not reimbursed, with an initial focus on compensating PCPs for preparing care plans for patients with multiple and complex conditions; and shared savings payments for meeting quality performance targets and reducing medical costs.
To participate in the shared savings aspect of the program, practices must meet quality performance goals, which include quality standards established by organizations such as the National Committee on Quality Assurance, the American Diabetes Association, the American Academy of Pediatrics and others. Those primary care physicians, however, who maintain or improve quality may earn up to 35 percent more than they earn today through the shared savings model.
Over time, Anthem estimates the program will substantially improve quality and member health, as well as improve overall medical costs as primary care practices transform themselves in order to better manage the health of their patient populations.
“Primary care physicians truly serve as the foundation for a healthier Maine,” Corcoran concluded. “And thanks to this program, PCPs will now have some of the necessary resources, along with the financial support and incentives, to maximize the potential of primary care to help our members live healthier lives, while responsibly reducing costs.”
Anthem Blue Cross and Blue Shield in Maine is the trade name of Anthem Health Plans of Maine, Inc., an independent licensee of the Blue Cross and Blue Shield Association. ®ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. Additional information about Anthem Blue Cross and Blue Shield in Maine is available at www.anthem.com. Also, please follow us on Twitter atwww.twitter.com/healthjoinin, on Facebook at www.facebook.com/HealthJoinIn, or visit our YouTube channel atwww.youtube.com/healthjoinin.