Blue Cross Blue Shield of North Carolina says it's going to reimburse primary care physicians more money if they can prove they're providing higher quality care. From the article:
The Chapel Hill-based insurer, which with nearly 152,000 enrollees is the largest health insurer in the Triad, has invited about 4,000 primary care physicians across the state to apply to join its Blue Quality Physician Program. The program is designed to reward quality over quantity. Physicians who meet the program’s criteria are eligible for double-digit percentage increases in standard reimbursements on some of the most commonly billed procedures.
BCBSNC will score applicants based on clinical quality outcomes, as measured by the National Committee for Quality Assurance, use of electronic prescribing, administrative efficiency and the physician’s ability to care for patients after-hours or electronically, among other criteria. Those who have scored high enough will qualify, while those who do not qualify can reapply.
Couple of things: I'm curious as to how I'm going to be cared for electronically. I'm tempted to get sophomoric and start talking about sticking electronic probes in interesting places, but I'll resist. Maybe they think the doctor can have me go "ahhhh" into a webcam and he can look at my tonsils online. Whatever.
What I'd really like to know is if I can base my reimbursement to BCBSNC on their quality of service? For every disputed claim we'll knock off double-digit percentages and for every drug not in their schedule we'll knock off even more. For every letter I get from my doctor saying my bill hasn't been paid and it's been, oh, 90 days we'll just waive the payment completely. Who will be our arbiter, our very own NCQA? Well, we'll found the Carolina Association of Righteously Pissed Patients (CARPP) and it will judge each claim based, in part, on BCBSNC's ability to care for patients at all without sucking over 15% of their gross income out of their pockets. Sound good?
