Insurer bets on PCPs to cut hospitalizations, costs

Primary care physicians (PCP) are in a difficult spot these days. Paid less than specialists, many jam their schedules with 15-minute appointments to bring in cash. Hospitals are buying up clinics, and some independent physicians are eager to join and leave the business-side headaches to someone else. Independence Blue Cross, which insures 2.2 million people in the Philadelphia area, is betting that these physicians will respond to a deal: more money in exchange for more help keeping patients out of the hospital.

Insurance companies, medical providers, and policymakers around the country are experimenting with different flavors of this idea, trying to change physicians’ incentives. Instead of rewarding practitioners for ordering more tests and treatments, these arrangements attempt to offer incentives for keeping patients well. Healthcare wonks often describe the shift as paying for value rather than volume.

Source: Bloomberg BusinessWeek