Bruce edwards carefirst login

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The program will reward doctors for taking measures to improve care, such as completing continuing education classes, using electronic records and ensuring patients get regular exams and close maintenance of chronic diseases. It will also analyze medical records and doctor-submitted claims to grade performances on health issues such as chronic disease maintenance for asthmatics, maintenance for diabetics and the incidence of heart disease in patients.

CareFirst, which insures about 3 million in the region, is hoping to keep patients healthier and save money by doing so, officials said. The insurer is briefing eligible doctors on the program in the coming weeks. Physicians in 11 specialties and subspecialties have until July 31 to register and submit information from this year, to receive their rate increase in early About 11, doctors are eligible, including those in family practice, pediatrics, internal medicine, cardiology and oncology.

CareFirst will allow 8, additional doctors in 14 more specialties to join late this year and submit information next year for a rate increase in Those include doctors in allergy and immunology, colon and rectal surgery, dermatology and plastic surgery.

Physicians in Maryland have long complained that the rates of reimbursement insurers pay them for their services are too low. The rate increase is based not on the rate doctors actually are paid, but on a standard fee CareFirst will not disclose, he noted.

Apart from economic rewards, the program could help guide doctors toward better methods of doing business, said Dr. CareFirst developed the 7 percent cap on the rate increase by looking at similar programs nationwide, Edwards said.

The number of pay-for-performance programs at insurers nationwide is growing, including in public programs such as Medicare, according to Francois de Brantes, CEO of national nonprofit Bridges to Excellence. The initiative also balances quality with cost concerns, ensuring that doctors who rate inefficient but with a high quality of care still can receive rate increases, de Brantes added.

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Anthony Shih, assistant vice president for quality improvement and efficiency at the Commonwealth Fund, a foundation that studies health issues. Paying doctors for the number of exams or procedures they perform, rather than how well they perform them, he said, results in a care system with "high volume but variable quality," in which doctors are not compensated for making efforts to keep patients healthy. So far, Shih said, most of the programs are so new that there aren't definitive studies of whether they reduce costs or improve quality.

It's also not clear whether the extra pay, typically between 2 percent and 8 percent above the standard payment, is enough incentive for doctors to take the extra steps needed to qualify, said Hildy Shaman, director of health industries for PricewaterhouseCoopers, who directed a study of such plans published in August.

Another problem: "They change the programs every year, and by the time you see the outcomes, the plan has changed," Shaman said. But Francois de Brantes, chief executive officer of Bridges to Excellence, an organization started by employers to promote changes in doctor and hospital reimbursement, said studies now being reviewed by medical journals for publication in the next several months will show that with well-designed incentives, doctors and hospitals "absolutely deliver quality care and are more efficient.

The efficiency, he said, is enough to pay for the costs of the bonuses, making the system no more costly overall. He added that most of the pressure for payment reform has come from employers, who are looking to keep their work force healthy and hold down medical costs. His organization endorsed CareFirst's effort - the first P4P program in the country to win that designation.

He said the designation program was just beginning, and that a "handful" of other programs would be recognized next month. As programs have become more widespread, physician groups, who initially opposed them, have begun to try to shape them, said Shaman of PricewaterhouseCoopers.

Martin Wasserman, executive director of MedChi, the state's largest organization of physicians, said Maryland's doctors welcome the program in principle. He praised CareFirst for using "evidence-based measures from physician-oriented groups.

On the other hand, Wasserman said, he was concerned that the emphasis on "better care, not more care," implies, dangerously, "if you provide more care, it's not good.

Ben Regalado, practice manager for Anesthesia Company, a doctor practice based in Annapolis, said the success of the program will depend on the details of administration and on physician and practice manager involvement as it's rolled out and refined. Participation in CareFirst's program is voluntary, but all doctors participating in CareFirst's network are eligible. Primary care doctors and internal medicine specialists can begin submitting data this year for higher pay next year.

More specialties will be added next year, with the prospect of bonus payments in CareFirst consulted advisory groups of doctors in developing the plan and will begin explaining it to all eligible doctors next month.

In the first phase, 11, doctors in family practice, pediatrics, internal medicine, cardiology, endocrinology, gastroenterology, hematology and oncology, infectious disease, nephrology, pulmonology and rheumatology. Mullen, president and chief executive officer of Mercy, said another key difference is that last year CareFirst was seeking a discount three to four times the savings Mercy thought it could generate.

This year, "our target is within reach - something our people can manage to. The hospitals and CareFirst declined to specify the exact size of the discount, saying that was proprietary. Mullen said Mercy's discount was "just a few percent. While the state rate-setting system doesn't allow pure volume discounts, Robert Murray, executive director of the cost review commission, said the cost-management plans made the savings "demonstrably achievable," and legal under Maryland regulations.

It remains unclear how much patient steering CareFirst can or will do, although John Ellis, executive vice president of finance and administration at St. Joseph, said "CareFirst has promised significant volume," and the contract specifies the insurer can't get the lower rates unless it meets volume targets.

Edwards said physicians who are employed by CareFirst would be directed to admit patients to the preferred hospitals whenever it is medically appropriate.

But most doctors in the CareFirst network simply contract with the HMO, but are not employees, and Edwards said he isn't sure how CareFirst would attempt to influence their decisions. Mullen said HMOs that try to steer patients can run into backlash. While most HMOs in the area admit patients to virtually every hospital, Mullen said, steering has been practiced for years in a variety of ways. Some HMOs have contracts with hospitals for specialized services, for example, and some doctors' practices are owned by hospitals.

Edwards said CareFirst did not have any projections of how much patient volumes would shift under the new arrangement. In Maryland, the only state that sets hospital rates, the cost review commission approves a charge for each hospital for each service - a day in a hospital room, a certain type of radiology procedure.

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While most HMOs in the area admit patients to virtually every hospital, Mullen said, steering has been practiced for years in a variety of ways. Some HMOs have contracts with hospitals for specialized services, for example, and some doctors' practices are owned by hospitals.

Edwards said CareFirst did not have any projections of how much patient volumes would shift under the new arrangement. In Maryland, the only state that sets hospital rates, the cost review commission approves a charge for each hospital for each service - a day in a hospital room, a certain type of radiology procedure.

However, many hospitals and insurers have negotiated, with approval of the commission, package rates for a certain type of service - say, a hip replacement.

CareFirst's contracts with Mercy and St. Joseph take that a step further, setting a package rate for all services, based on the patient's disease or procedure, such as a birth, a heart bypass or a pneumonia treatment. Ellis said the new deals are similar to one St. Joseph has with Cigna, and two it had with now-defunct physician groups, Doctors Health and Maryland Personal Physicians. Also, he said, it is virtually identical to the way Medicare pays hospitals outside Maryland.

Since the hospital is getting a fixed rate for each patient, it doesn't have to worry about whether CareFirst will later refuse to pay part of the bill because it thinks the patient received unnecessary services or stayed in the hospital too long. Such "retrospective denials" have been a source of contention between the hospitals and the insurers, especially CareFirst. To keep costs down - and justify the discounts - Edwards said CareFirst will help hospitals with discharge planning and with "hospitalists" - doctors who work full time in the hospital and monitor the care patients are getting.

William Salganik. The change means nurse practitioners will be able to bill the insurer and be considered a primary care network provider. According to the Association of American Medical Colleges, there will be 32 million additional Americans getting health care coverage due to health care reform, which will lead to an estimated shortage of 63, doctors across all specialties in Nurse practitioners had been allowed to participate in the networks before Thursday, but only in underserved areas with limited access to primary care physicians.

Nurse practitioners participating in the network will have to meet CareFirst credentialing criteria and must attest that they have a written collaborative agreement with a physician of the same specialty who is also in the CareFirst provider network on file with the state. And, being able to bill CareFirst could encourage nurse practitioners to go into business for themselves.

If we can now open our own businesses, think of the underserved people who will now have access to primary care. According to the American Academy of Nurse Practitioners, as of , there are about , practicing nurse practitioners in the U.

The academy said about million visits are made annually to nurse practitioners. In Maryland, there are about 3, nursing practitioners, according to the Nurse Practitioner Association of Maryland.

Tagged with: nurses physicians. We can provide affordable health care to all if the corporations and special interests could be removed from the equation and doctors and nursess allowed to do their jobs with recertificaiton and continuing education and licensing. Ben Mook. One comment. Jim Foster November 6, at am. We use cookies on our website to give you the most relevant experience by remembering your preferences and repeat visits.