Dive Brief:
- Blue Cross Blue Shield of MA is planning to extend global budgets to its preferred provider organization (PPO) health plans.
- The new payment model would reward medical groups for keeping patient costs below budget.
- Many providers believe the move may end up costing them, and want their concerns to be addressed before committing.
Dive Insight:
Many physicians in BCBS of MA's HMO networks are already operating under global budgets, and the carrier believes extending global budgets to PPOs could be an incentive for physicians to better manage costs. However, the greater freedoms allowed to patients with PPOs have physicians wondering if they might have trouble managing costs and end up losing money. Providers have questions they want answered before they are willing to commit.
BCBS of MA says providers who are not willing to make the move will still be allowed to participate in their PPO networks under the current fee-for-service payment model.