Is your primary care doctor’s office calling you more, nudging you to get your cholesterol re-checked, to get a flu shot, to follow up that suspicious mammogram or to get your first screening colonoscopy?
Bon Secours Medical Group and Patient First have signed agreements with Anthem, the state’s largest health insurer, in which Anthem pays primary care doctors more for taking care of patients and rewards them if patient outcomes improve.
The focus is on what’s called patient-centered medical homes in which a primary care provider oversees and coordinates a patent’s care, which is often fragmented if a patient has complex medical problems and sees multiple providers.
“Care coordinated by primary care doctors is associated with better outcomes,” said Dr. Jay Schukman, chief medical director for Anthem.
Anthem’s parent company, WellPoint, launched the patient-centered primary care program in January, describing it as a “fundamental change” in its relationship with primary care physicians.
In addition to paying primary care doctors more, the initiative pays doctors for non-visit services such as preparing care plans for patients with complex medical conditions.
Anthem so far has signed agreements with six large medical practices in Virginia. Along with Bon Secours Medical Group and Patient First, the others are Fairfax Family Practice Centers, Tidewater Physicians Multispecialty Group, Bayview Physicians Group and Carilion Clinic.
“We are focusing on primary care physicians because they are better equipped to provide whole-patient care,” Schukman said.
“One of the things we are going to be sharing with the doctors is something called Member Medical Health Plus. This particular information will have which doctors these patients have seen, the individual demographics for these patients, the diagnosis, admissions of the hospital, procedures performed on the patients, lab results,” Schukman said.
Bon Secours Medical Group has been transforming its primary care medical offices to a patient-centered model since a pilot project in June 2010.
“Practice by practice, we have been doing this clinical transformation project which revolves around building our medical home, aggressive and robust use of electronic medical records,” said Robert J. Fortini, vice president and chief clinical officer for Bon Secours Medical Group.
The multi-specialty practice with medical offices in the Richmond area and Hampton Roads has about 200 primary care doctors.
“Anthem is one of our large commercial payers, so it’s satisfying to see that they’ve recognized how important the changes we’ve made are by crafting this initiative,” Fortini said.
“We hope to complete these types of relationships with all of our payers, including the government. … I really see this type of a comprehensive approach to prevention and wellness as the cure for the health care woes we have at the moment.”
Patient First, which has 97 physicians practicing in Virginia, serves as primary care provider for 77,800 patients in the state, a spokesman said.
“Participating with Anthem in its patient-centered medical home program is a great fit for Patient First as we continue our mission to provide convenient, cost-effective care,” said Dr. Victoria Rennie, medical director at Patient First’s Mechanicsville location.
Anthem’s Schukman said the company has offered agreements to eight more large medical practices, and in 2013 it will add six more physician groups.