Blue Cross and Blue Shield of Illinois Partners with Largest Independent Physician Group on New Value-Based Care Model

Aug 06, 2015, 11:57 ET from Blue Cross and Blue Shield of Illinois

CHICAGO, Aug. 6, 2015 /PRNewswire-USNewswire/ -- Blue Cross and Blue Shield of Illinois (BCBSIL) announced today that it has signed an agreement to launch an innovative new value-based care model with DuPage Medical Group (DMG), the largest independent physician practice in the Chicago area, with more than 425 doctors.

"This really is a game-changer for independent physicians," said Opella Ernest, M.D., divisional senior vice president and chief medical officer for Blue Cross. "We recognize the challenges doctors face when they want to move their practice from fee-for-service reimbursement to a value-based care model, and through this landmark partnership, we'll make it possible for independent physicians to participate in value based care in a meaningful way."

In traditional fee-for-service arrangements, reimbursement is based on specific services provided to patients; rewarding providers for the volume of services they provide.  In value-based care, payment to providers is associated with meeting quality or performance measures.  Providers receive increased levels of reimbursement for delivering services to better manage care and avoid costly encounters, such as hospitalizations. 

The new model, called BCBSIL Practice Advancesm, is a new innovative physician engagement model that aids independent physicians in providing quality, cost-effective care to their patients.  For consumers, BCBSIL Practice Advancesm means enhanced coordinated care that focuses on quality and improved health outcomes. The model provides a platform for health care innovation designed to develop joint initiatives that promote the provision of high-quality, cost effective care.  Blue Cross anticipates expanding this innovative new approach to other physician organizations beyond DMG.

Michael Kasper, chief executive officer of DMG, explains, "This is a real opportunity for direct access to quality and cost data that will help inform decisions about how best to care for our patients.  Blue Cross is making this level of transparency possible, something that wouldn't otherwise be available to us."

"We are proud to be physician led and directed. This agreement affirms our belief that we can influence the healthcare system and ensure patients receive the best care possible. We are pleased to be part of this innovative care model, and look forward to other physicians joining us as participants," added Paul Merrick, M.D., President of DuPage Medical Group.

About Blue Cross/Blue Shield of Illinois (BCBSIL)

With 8 million members, BCBSIL, a division of Health Care Service Corporation, a Mutual Legal Reserve Company, is the largest health insurance company in Illinois. Begun in 1936 in Chicago, BCBSIL remains member owned rather than publicly traded, and is committed to promoting the health and wellness of its members and its communities, fostering greater access to care, and working to lower the overall cost of care while improving care quality and patient outcomes.

About Du Page Medical Group
With more than 425 physicians and in more than 60 locations, DuPage Medical Group is the largest, independent, multi-specialty physician group in the Chicago area, providing physician-directed health care focused on quality, efficiency and access. For more information, visit www.dupagemedicalgroup.com.

 

SOURCE Blue Cross and Blue Shield of Illinois



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