WellPoint's Pay Raise for Primary Care Doctors - Texas Journal of Chiropractic

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WellPoint's Pay Raise for Primary Care Doctors

Published 02/17/2012 - 1:12 p.m. CDT

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The American Medical Association REPORTS HERE that "health insurers have been busy the last several years talking about how best to promote the use of primary care. Now the country's second-largest health plan has promised what some physicians say has been lacking from other efforts: a pay raise for primary care doctors."

"Indianapolis-based WellPoint announced in January that it planned to give primary care physicians a roughly 10% increase in pay and a chance to share savings that stem from improved outcomes for their patients. It plans to roll out the primary care pay raise market by market beginning in the fall, said Jill Hummel, vice president of payment innovation at WellPoint."

"A study in the Journal of General Internal Medicine in January 2011 found that primary care physicians spent about 20% of their day on care management tasks that are mostly unpaid. It's that kind of work that Eugene Heslin, MD, refers to as the "intellectual" rather than "procedural" side of medicine."

"Primary care physicians have been under-reimbursed compared to the responsibilities they are asked to handle," Dr. Heslin said.

"WellPoint will boost what it pays for primary care without requiring that a practice become certified as a medical home, but it will require participating practices to adopt "patient-centered practice principles," Hummel said.

"We're trying to reach those physicians that may not have had the ability to transform yet," she said.

"WellPoint is parent of for-profit Blues plans in 14 states from California to Vermont. It managed benefits for 34.3 million people at the end of 2011. … Network physicians who want to participate will sign a contract addendum, including a pledge to adopt patient-centered practice principles, Hummel said. That will earn them a boost in pay that will depend on the market but will average about 10% above their current fee schedule, she said. The physician can earn even more through the shared savings portion of the program, which will be calculated annually."

"The health plan expects to save money when members benefit from patient-centered primary care. That savings will offset higher payments to physicians. 'Specialists certainly continue to play an important role in the system, but we want that primary care physician to re-establish themselves as the captain,' Hummel said."

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