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  1. Annual Report
  2. Standing Strong with Our Clinician Partners
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Standing Strong with Our Clinician Partners

We supported physicians and hospitals by advancing payments, easing administrative requirements and creating a new value-based payment program for independent primary care practices, with incentives to improve quality and lower costs.

Accelerating payments for our members’ clinicians

When our clinician partners were hit with a steep drop in office visits, elective procedures and non-urgent hospital services, along with the unanticipated costs of pandemic safety measures, we set up new billing guidelines to ensure payment for care delivered at field hospitals and other alternative sites, eased administrative requirements – including prior authorizations and referrals – for COVID-19 care, and made necessary adjustments to ensure that we could process claims promptly and efficiently. We also stepped in to provide a financial boost by accelerating payments to primary care practices that participate in our value-based programs.

Read More about the impact of our value-based payment programs.

Offering value-based payment models to smaller physician practices

By partnering with large physician groups, we’ve had more than a decade of success in improving the quality of care while controlling health care costs through our Alternative Quality Contract. Now, we’ve launched a pilot program to include smaller, independent primary care practices. The pilot provides participating practices with a “global” pool of money for patients and flexibility in how to use it, rather than the traditional “fee-for-service” method of reimbursement for office visits, tests or procedures.

Read more

Honoring clinicians on the front lines

When the pandemic began, there was no known treatment or cure, no natural immunity. But patients could count on the courage, ingenuity and compassion of clinicians working in emergency rooms, intensive care units, clinics and field hospitals. During the outbreak, our Coverage news service has given hospital staff the opportunity to share their most personal and urgent thoughts, concerns and advice with the public.

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ATANSYON: Si ou pale kreyòl ayisyen, sèvis asistans nan lang disponib pou ou gratis. Rele nimewo Sèvis Manm nan ki sou kat Idantitifkasyon w lan (Sèvis pou Malantandan Rele 1-800-472-2689 TTY: 711 ).

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ការជូនដំណឹង៖ ប្រសិនប. ើអ្នកនិយាយភាសា ខ្មែរ សេ  វាជំនួយភាសាឥតគិតថ្លៃ គឺអាចរកបានសម្  រាប ់អ្នក។ សូមទូរស័ព្ទទ ៅផ ្នែ កសេ  វាសមា  ជិកតាមល េខន  ៅល.  ើប ័ណ្ណ សម្  គាល ់ខ្លួ ខ្លួ នរប ស់អ្នក ហៅ  1-800-472-2689 (TTY: 711) ។

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ຂໍ້ຄວນໃສ່ໃຈ: ຖ້າເຈົ້າເວົ້າພາສາລາວໄດ້, ມີການບໍລິການຊ່ວຍເຫຼືອດ້ານພາສາໃຫ້ທ່ານໂດຍບໍ່ເສຍຄ່າ. ໂທ ຫາ ຝ່າຍບໍລິການສະ ມາ ຊິກທີ່ໝາຍເລກໂທລະສັບຢູ່ໃນບັດຂອງທ່ານ ໂທ 1-800-472-2689 (TTY: 711).

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