WellPoint Launches Innovative Reimbursement Initiative, Partnering With Primary Care Physicians To Improve Quality And Reduce Medical Costs

WellPoint, Inc. (NYSE: WLP) announced today an innovative, patient-centered primary care program that will fundamentally change its relationship with primary care physicians by significantly increasing the company’s investment in their practices and in the health of their patients.

Through this initiative, WellPoint will make a major investment in primary care by increasing revenue opportunities for participating primary care physicians, enhancing information sharing, and providing care management support from WellPoint clinical staff. The new program will also incorporate best practices from the company’s multiple medical home pilots.

“Primary care physicians who are committed to expanding access, to coordinating care for their patients and being accountable for the quality of care and the health outcomes of those patients, will get paid more than they do today, and we’re committed to helping them achieve these quality and cost goals,” said Dr. Harlan Levine, WellPoint executive vice president, Comprehensive Health Solutions. “Primary care is the foundation of medicine, and it can and should be the foundation of our members’ health.”

WellPoint’s patient-centered primary care program builds and expands upon its successful medical home programs.

“Our medical home pilots have proven to make a meaningful difference in patient quality, outcomes and cost. Some of our pilots have experienced an 18 percent decrease in acute inpatient admissions and a 15 percent decrease in total ER visits while improving compliance with evidence-based treatment and preventative care guidelines,” said Levine, who is responsible for leading the company’s payment innovation strategies.

“This innovative program expands on the medical home concept and recognizes and rewards primary care doctors for their impact on improving health outcomes,” said Dr. Gary S. Mirkin, CEO of Allied Pediatrics, which participates in the patient centered medical home for WellPoint’s affiliated health plan in New York. “Thanks to WellPoint’s dedication to this program, primary care physicians now have some of the necessary tools to begin unleashing the true potential of primary care to provide higher quality services for our patients while responsibly reducing costs. It is my hope that other insurers will follow WellPoint’s lead so that every patient can have his or her own medical home.”