Blue Cross and Blue Shield of Illinois (BCBSIL) has signed an agreement to launch an innovative new value-based care model with DuPage Medical Group (DMG), the largest independent physician practice in the Chicago area, with more than 425 doctors. Traditionally in a fee-for-service delivery model, reimbursement is based on specific services provided to patients; rewarding providers for the volume of services they provide. In value-based care, payment to providers is associated with meeting quality or performance measures. Providers receive increased levels of reimbursement for delivering services to better manage care and avoid costly encounters, such as hospitalizations. The initiative will deliver direct access to quality and cost data that will help inform decisions about how best to care for patient populations.
New Value-based Model Details
The new value-based model dubbed BCBSIL Practice Advance, is a new innovative physician engagement model that aids independent physicians in providing quality, cost-effective care to their patients. For consumers, BCBSIL Practice Advancesm means enhanced coordinated care that focuses on quality and improved health outcomes. The model provides a platform for health care innovation designed to develop joint initiatives that promote the provision of high-quality, cost effective care. Blue Cross anticipates expanding this innovative new approach to other physician organizations beyond DMG.
“This really is a game-changer for independent physicians,” said Opella Ernest, M.D., divisional senior vice president and chief medical officer for Blue Cross. “We recognize the challenges doctors face when they want to move their practice from fee-for-service reimbursement to a value-based care model, and through this landmark partnership, we’ll make it possible for independent physicians to participate in value based care in a meaningful way.”
