I saw an article in last week’s Times Union that caught my eye. The article discusses how Capital District Physicians Health Plan (CDPHP), the Capitol Region’s largest insurer, is expanding a new payment model to encourage better coordinated primary care. CDPHP is moving away from the “fee-for-service” payment model for primary care doctors. Instead, the insurer is giving doctors a monthly payment for each CDPHP member — regardless of whether the patient visits the doctor or not. The company will also offer a potential financial bonus to doctors who keep their patients healthy and out of the hospital.
The model encourages physicians to communicate with patients via phone and email and to allow nurse practitioners to treat less complicated cases so that doctors can spend more time with higher need patients. CDPHP has been testing the payment model at three local primary care practices with a pool of roughly 13,000 patients and plans to expand the program to 73 practices and 100,000 patients by 2013. By all accounts the new payment model has been a success. CDPHP reports that patients are healthier, insurance claims are down and physicians earned more. The text of the full article is available here.
-Jaime Venditti, 3/20/12