Empire BCBS Now Rewards Physicians for Using Best Practices

Empire Blue Cross Blue Shield of New York, serving about 5 million members, is now instituting a pay-for-performance program that rewards physicians with greater reimbursement for complying with certain best practices. The aim is to encourage physicians to adopt best practices, so those who do not meet the standards will not be penalized. The factors included in the considerations are the use of electronic health records, statins for patients with coronary artery disease, beta blockers for patients after a heart attack, and avoiding the unnecessary use of antibiotics for adults and children for certain respiratory illnesses. As of August, the program, available for all commercial plans, includes an additional 3-5% above the standard fee schedule for visit codes. BCBS has implemented this program in other states, as well, including Connecticut.

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