BCBS of KS Offers Incentives For Care Plan Development

Here’s more examples of the growing link between payment and quality: BCBS of Kansas is paying nearly 7% increases to providers for demonstrating quality and CareFirst is now offering higher payments for “developing care plans” under its Patient Centered Medical Home program, and then up to an 80% fee schedule increase to providers who turn these care plans into savings (aggregate costs being less than expected costs)

At an event I attended in December in Connecticut to discuss the impact of the Newtown Sandy Hook school shooting on mental health policy, a Hartford Hospital physician called for insurers to be required to “prove” that care is not medically necessary, rather than have physicians and patients have to prove it, especially in “rural areas” and as patients transition from youth age to adult when access can be difficult (in attendance were representatives from 2 major insurers) 

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