Wallingford nonprofit insurer HealthyCT is joining the race to test new payment models that aim to improve care coordination and reduce healthcare costs.
The insurer, which is only in its second year of existence, is launching an Advanced Practice Medical Payment Model (A-PMPM) program that offers incentives to physicians who adopt a patient-centered medical home, which is a form of patient care that involves a deep level of coordination among the insurer’s member physicians and other healthcare providers.
A patient-centered medical home requires a physician practice to make additional contact with a patient following a visit to ensure he or she is taking medicine, obtaining routine tests or getting follow-up care. This coordination requires additional staff time and resources that typically aren’t reimbursed by insurers.
Under the A-PMPM program, primary care doctors can earn additional reimbursement by providing the added level of care to patients with chronic illnesses, including diabetes, heart disease, and other conditions that could become life threatening if left unchecked and uncoordinated. HealthyCT partnered with more than a dozen physician practices across the state and Qualidigm to develop the program. – GREG BORDONARO
