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Quality care brings physicians higher pay

A North Carolina Blues program extends a 2006 Bridges to Excellence pilot to reward doctors who meet specific quality standards.

By Emily Berry — Posted March 18, 2010

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BlueCross BlueShield of North Carolina has started paying nearly three dozen primary care physicians at higher rates as part of a statewide pay-for-performance program.

The North Carolina Blues plan sent 4,000 family physicians, internists, pediatricians and ob-gyns information about the program in December 2009, and as of early March, 32 physicians at six practices were participating, spokesman Kyle Marshall said. The company is hoping to have 250 physicians enrolled in the program by year's end.

Senior Medical Director Gene Komives said participants would be paid at "significantly higher" rates, amounting in some cases to a double-digit percentage increase.

The additional pay will recognize practices that have achieved a series of quality designations, most importantly certification as a patient-centered medical home or physician practice connection practice by the National Committee for Quality Assurance.

The program, called Blue Quality, builds on what Dr. Komives said was a successful Bridges to Excellence pilot begun in 2006, ultimately involving 250 physicians. Bridges to Excellence is an employer-sponsored program that aims to promote quality improvement and cost efficiency in medicine.

Most of the participants in the pilot achieved one of the two NCQA designations that now qualify them for higher pay, Dr. Komives said.

It's too early to tell whether the new statewide program will improve the health of Blues members, but the pilot program resulted in measurable reductions in specialist visits, high-tech imaging and hospitalizations, Dr. Komives said, probably because better care coordination made them unnecessary.

"We've not told these physicians, 'You need to reduce utilization,' " she said. "We've told them, 'You need to coordinate care.' "

The North Carolina Medical Society said it was aware of the program but was not involved in its design or implementation.

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