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Value-based programs

Arkansas Blue Cross and Blue Shield and our family of companies have been working with doctors, hospitals and state and federal government organizations to develop value-based care programs in Arkansas.

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Value-Based Care

Value-based care focuses on getting value from quality services. It is a shift from fee-for-service, or volume-based care.  With value-based care, payments to doctors and hospitals are partially based on keeping people healthy, rather than simply the number of tests or services performed. Physicians are rewarded for coordinating care, providing appropriate care, preventive services, and for positive health outcomes.

The following programs are available to doctors and/or hospitals in the Arkansas Blue Cross networks.

Performance-based programs (PCMH and CPC+)

  • Patient-Centered Medical Home (PCMH)

    The patient-centered medical home (PCMH) model is a method to deliver and organize healthcare that helps to improve the patient’s experience of care, improve the health of populations, and reduce or control the costs of healthcare. The PCMH model allows the primary care physician and the patient to be in the center of the healthcare system, to know what is going on and help the patient be in control of their health.

    For more information, see the Primary Care Representative contact information below, or contact Arkansas Blue Cross Primary Care at 501-378-2370 or primarycare@arkbluecross.com.

  • Comprehensive Primary Care Plus (CPC+)

    CPC+ is an advanced primary care medical home model that rewards value and quality by offering an innovative payment structure to support delivery of comprehensive primary care.

    Arkansas Blue Cross partners with CMS in this five-year national model to strengthen primary care in Arkansas.  CPC+ seeks to improve quality, access, and efficiency of primary care. CPC+ in Arkansas began January 2017 and will run through 2021. CMS.gov

Collaborative Health Initiatives (CHIs)

CHIs are groups of doctors, hospitals and other healthcare professionals that come together to provide coordinated high-quality care. They are similar to accountable care organizations.

Arkansas Blue Cross collaborates with primary care physicians within a CHI to jointly manage the quality and efficiency of care. Through this collaboration, the CHIs and Arkansas Blue Cross work together to meet quality and financial targets.