Wellpoint Expands Primary Care Payments
The expansion includes raised payments and payments for currently unreimbursed services such as creating patient care plans. They also unveiled a shared-savings program, up to 30% and plans to invest in staffing and data sharing in exchange for measures such as participating in monitoring programs and offering 24 hour access. Wellpoint plans to invest $1 billion. They hope to achieve savings of up to 20% from improved health and reduced use of costlier services (ER visits).
Wellpoint companies include Anthem Blue Cross & Blue Shield in Virginia. Wellpoint is taking a business risk by pursuing this investment. Since providers tend to contract with several insurers competitors may take advantage of the program without making a similar investment or taking on similar risk of loss. This free rider problem may have discouraged insurance companies from aggressively pursuing cost-savings–at least until now.