WellPoint 'Leaves No Primary Care Practice Behind'
on Road to Value-Based Payment Reform

To foster its ambitious goal of moving 75 percent of its physician practices from visit- to value-based reimbursement over the next three years, WellPoint has placed a variety of resources at the practices' disposal.

Building on its successes with the patient-centered medical home, a model it has deployed since 2008, WellPoint is transitioning its practices from a fee-for-service world to one that rewards doctors when they improve both the quality and affordability of the care they provide. The payment reform starts with a care coordination fee for activities that are not "visit"-based. Once physicians meet an established quality gate, they are eligible to share in any savings achieved.

Supports for providers in WellPoint's 14 markets as they transition to the new payment system are designed to meet the needs of all its practices — from small individual practices to large integrated health systems, explained Julie Schilz, director of care delivery transformation for WellPoint during a recent webinar, Aligning Value-Based Payment with Physician Practice Transformation.

Julie Schilz

"We have a 'Leave No Primary Care Practice Behind' philosophy," said Ms. Schilz. "Some practices have wonderful systems or enhanced capabilities, like a Patient-Centered Medical Home recognition. How we bring ourselves to these practices certainly looks different than [our presentation to] a practice just starting on its transformation journey."

Resources range from toolkits, Web-based care delivery software and a learning collaborative that offers live and recorded training sessions and virtual "call-in" hours to access to three consultants with distinct areas of expertise.

In case you missed this webinar, you still have a chance to watch this highly-rated program.

Register to view the conference today or order your training DVD or CD:

You can "attend" this program right in your office and learn about the three practice transformation roles developed by Wellpoint that address the critical elements of transformation; how the physician practice transformation program complements Wellpoint's overall reimbursement strategy with fee-for-service and a shared savings component; the Quality Gate for clinical and utilization metrics for WellPoint's shared savings arrangement; overcoming physician resistance to practice transformation...especially transformation driven by a healthcare payor; and how the practice transformation program is evolving, including how the program is building a bridge between primary care and specialty practice transformation to create a medical neighborhood.

It’s so convenient! Invite your staff members to watch the conference. We will send you a DVD or CD-ROM of the conference proceedings or a link to our web site with a username and password. You can log in and view the program right from your computer — any time of the day or night, whenever convenient for you and your colleagues — and benefit from the archived recording of the conference, including the Q&A period.

You'll get to listen to the question and answer session to hear about the type of data exchange necessary between physician practices and healthcare payors to support value-based reimbursement; the components of a care compact between specialists and the PCP's in WellPoint's medical home neighborhood; how to work with IPAs and PHOs in a value-based system; gaps in care reporting; and how WellPoint members are incentivized around patient-centered goals.

To register for the on-demand re-broadcast, download an .MP3 file or order the training DVD or CD-ROM of Aligning Value-Based Payment with Physician Practice Transformation, please visit:

I hope you find it useful.


Melanie Matthews
Executive Vice President
The Healthcare Intelligence Network

P.S. -- You may also be interested in these resources on value-based reimbursement: