Blue Cross partners with B.R. General Physicians on ‘medical home’

Blue Cross and Blue Shield of Louisiana is partnering with the Baton Rouge General Physicians group on a “patient-centered medical home” pilot project, says Dr. Ken Phenow, chief medical officer with Blue Cross. The program will be rolled out Jan. 1. Fee-for-service payments will continue in the short term, although Blue Cross hopes to slowly decrease fee-for-service reimbursement in favor of other payment methods, including a “care coordination fee” paid up front and a “performance fee” on the back end for providers who improve outcomes and reduce costs. Doctors will have the opportunity to share in the savings when they reduce costs for the population served by the medical home, as compared to the general population in the market. “We want to promote primary care” while “bending the cost curve” downward, Phenow says. “We want to focus on helping people be healthy, and get to a holistic approach to health care.” Phenow expects doctors in this model will think twice before ordering expensive tests or procedures, yet still will be held accountable for the health of the population they serve. He says the model works best with large practices serving 10,000 or so patients, so Blue Cross is looking into creating virtual medical homes by bringing multiple providers together; a pilot program to that effect is being developed in the Shreveport area. The Baton Rouge Clinic also has expressed interest in a medical home model for some of their primary care physicians, Phenow says. —David Jacobs