Blue Cross medical director wants to boost primary care docs

Primary care doctors are in some ways the foundation of health care, yet are paid far less on average than specialists. But Dr. David Carmouche, hired this fall as the medical director for Blue Cross and Blue Shield of Louisiana, says the state’s dominant insurer is investing in primary care. “We’re engaging the people who for the longest time have been the most disadvantaged by the current system,” he says. “If you look at reimbursement to primary care doctors, they’re on the low end of the pay scale compared to everybody else. They feel they bring great value and have great potential, they just never had a payment model to reward them. And now we’re offering that to some degree.” Blue Cross will be negotiating new agreements with provider groups in 2013, and hopes to help some of them change their delivery model with a primary care-focused strategy. If you call your CPA, he says, you might get a bill for a 15-minute phone call, but medical practices may not get paid for doing the same sort of work with their complex patients. “For those [provider] groups, it’s talking about how we can identify the measures of success, and put some money in it for primary care doctors,” he says. –David Jacobs