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Wellpoint to Begin Paying Family Practice Doctors a “Little” More–Enough to Make A Difference? Pay For Their F

Posted Jan 27 2012 10:05pm

Ok so I made my point in the title and this article too dissects the potential demographics of the situation too as if only 10-20% of the patients are covered by Blue Cross, is there enough incentive for the doctors to make a difference?  On the other hand if the insurer paid all their insurer overhead, now that would make a huge difference and get attention.  Let’s also look at the amount of the investment here since doctors only represent 8% of healthcare expenses. image

Certainly the clinical information shared is always of value as knowledge helps all the way around.  For those doctors going broke as this recent article talked about, and there’s a lot of truth to this in the family practice area for sure, this won’t make a dent and there are doctors in affluent areas like Newport Beach, CA also going broke, so go figure. 

Best I can figure is that some numbers were crunched and some new algorithms were produced to show an effort here and that’s kind of what I see here to make news and show something positive, you think?  Speaking of Newport Beach, acquisitions by other insurers are creating problems too so when insurance contracts are not being bounced around maybe this tiny incentive that is built up to be such a big story will help? 

United Healthcare Acquisition of Monarch Healthcare HMO Already Causing Confusion and Access Problems for Blue Shield Patients in Orange County

So what does this promise of Wellpoint giving doctors data and staffing entail?  Are they going to cover the doctor’s red tape billing expenses?  Don’t hold your breath on that one but I guess more will roll out later but the staffing I am guessing will be more in the area of efficiencies for them to “improve” and how that rolls out will remain to be seen too.  If all the insurers kicked in to cover all the doctor’s billing expenses that would be a story

The nation's second-largest health insurer is shaking up its approach to paying doctors, putting a major investment behind the idea that spending more for better primary care can save money down the road.

Starting this summer, WellPoint Inc., which insures some 34 million Americans, will offer primary-care doctors a fee increase, typically of around 10%, with the possibility of additional payments that could boost what they get for treating the patients it covers by as much as 50%.

The new approach could pour an additional $1 billion or more into primary care, which WellPoint is betting will pay off in the form of fewer emergency-room visits and hospital stays.

Primary-care doctors, such as pediatricians and family physicians, often make less than half of what top-paid specialists like orthopedic surgeons earn, and the idea of changing how they are paid has been around for years. Insurers and government agencies are experimenting with a variety of approaches. But WellPoint, with its network of about 100,000 primary-care doctors, could have a much broader influence.

The impact could be amplified by another new effort, by health insurer Aetna Inc., which will start paying the 55,000 primary-care doctors across its network an extra fee—of $2 to $3 per patient per month—if their practices are certified as meeting certain standards for providing access for patients and coordinating their care.


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