Blue Cross and Blue Shield of Illinois Partners with DuPage Medical Group on New Value-Based Care Model

CHICA­GO – Blue Cross and Blue Shield of Illi­nois (BCB­SIL) announced today that it has signed an agree­ment to launch an inno­v­a­tive new val­ue-based care mod­el with DuPage Med­ical Group (DMG), the largest inde­pen­dent physi­cian prac­tice in the Chica­go area, with more than 425 doctors.

“This real­ly is a game-chang­er for inde­pen­dent physi­cians,” said Opel­la Ernest, M.D., divi­sion­al senior vice pres­i­dent and chief med­ical offi­cer for Blue Cross. ​“We rec­og­nize the chal­lenges doc­tors face when they want to move their prac­tice from fee-for-ser­vice reim­burse­ment to a val­ue-based care mod­el, and through this land­mark part­ner­ship, we’ll make it pos­si­ble for inde­pen­dent physi­cians to par­tic­i­pate in val­ue based care in a mean­ing­ful way.

In tra­di­tion­al fee-for-ser­vice arrange­ments, reim­burse­ment is based on spe­cif­ic ser­vices pro­vid­ed to patients; reward­ing providers for the vol­ume of ser­vices they pro­vide. In val­ue-based care, pay­ment to providers is asso­ci­at­ed with meet­ing qual­i­ty or per­for­mance mea­sures. Providers receive increased lev­els of reim­burse­ment for deliv­er­ing ser­vices to bet­ter man­age care and avoid cost­ly encoun­ters, such as hospitalizations. 

The new mod­el, called BCB­SIL Prac­tice Advance^sm, is a new inno­v­a­tive physi­cian engage­ment mod­el that aids inde­pen­dent physi­cians in pro­vid­ing qual­i­ty, cost-effec­tive care to their patients. For con­sumers, BCB­SIL Prac­tice Advance^sm means enhanced coor­di­nat­ed care that focus­es on qual­i­ty and improved health out­comes. The mod­el pro­vides a plat­form for health care inno­va­tion designed to devel­op joint ini­tia­tives that pro­mote the pro­vi­sion of high-qual­i­ty, cost effec­tive care. Blue Cross antic­i­pates expand­ing this inno­v­a­tive new approach to oth­er physi­cian orga­ni­za­tions beyond DMG. Michael Kasper, chief exec­u­tive offi­cer of DMG, explains, ​“This is a real oppor­tu­ni­ty for direct access to qual­i­ty and cost data that will help inform deci­sions about how best to care for our patients. Blue Cross is mak­ing this lev­el of trans­paren­cy pos­si­ble, some­thing that wouldn’t oth­er­wise be avail­able to us.”

“We are proud to be physi­cian led and direct­ed. This agree­ment affirms our belief that we can influ­ence the health­care sys­tem and ensure patients receive the best care pos­si­ble. We are pleased to be part of this inno­v­a­tive care mod­el, and look for­ward to oth­er physi­cians join­ing us as par­tic­i­pants,” added Paul Mer­rick, M.D., Pres­i­dent of DuPage Med­ical Group.

About Blue Cross/​Blue Shield of Illi­nois (BCB­SIL)

With 8 mil­lion mem­bers, BCB­SIL, a divi­sion of Health Care Ser­vice Cor­po­ra­tion, a Mutu­al Legal Reserve Com­pa­ny, is the largest health insur­ance com­pa­ny in Illi­nois. Begun in 1936 in Chica­go, BCB­SIL remains mem­ber owned rather than pub­licly trad­ed, and is com­mit­ted to pro­mot­ing the health and well­ness of its mem­bers and its com­mu­ni­ties, fos­ter­ing greater access to care, and work­ing to low­er the over­all cost of care while improv­ing care qual­i­ty and patient outcomes.

About Du Page Med­ical Group

With more than 425 physi­cians and in more than 60 loca­tions, DuPage Med­ical Group is the largest, inde­pen­dent, mul­ti-spe­cial­ty physi­cian group in the Chica­go area, pro­vid­ing physi­cian-direct­ed health care focused on qual­i­ty, effi­cien­cy and access. For more infor­ma­tion, vis­it www​.duly​healthand​care​.com