Medical home staffing covered by BCBS

March 10, 2011

A New Jersey Blue Cross Blue Shield affiliate is paying for a population care coordinator for primary care practices as part of a patient-centered medical home pilot program that compensates practices using bundled payments.

A New Jersey Blue Cross Blue Shield affiliate is paying for a population care coordinator for primary care practices as part of a Patient-Centered Medical Home (PCMH) pilot program that compensates practices using bundled payments.

Horizon Healthcare Innovations LLC, a subsidiary of Horizon Blue Cross Blue Shield of New Jersey, launched this pilot PCMH program with 63 primary care physicians, serving 24,000 Horizon members. The program will pay physicians' care coordination fees for providing comprehensive care for its members rather than with a traditional fee-for-service model. If the PCMH practice demonstrates better outcomes and more efficient care for Horizon members, those practices have the opportunity to earn more money, with the ultimate goal being better patient outcomes at lower overall cost, according to Horizon.

To help physician groups achieve these benchmarks, population care coordinators funded by Horizon will work on-site at the physician offices and provide clinical and administrative support to each practice. Horizon also will provide coaches to help primary care physicians transform their practices into a medical homes, according to the insurer.