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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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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, and for positive health outcomes. The following programs are available to doctors and hospitals in the Arkansas Blue Cross, Health Advantage and BlueAdvantage Administrators of Arkansas networks.

Primary care

Comprehensive Primary Care Plus

Patient-Centered Medical Home (PCMH)

Episodes of care

Overview

Please be advised that Arkansas Blue Cross is phasing out its Episodes of Care Program. This will allow Arkansas Blue Cross to focus resources on its current efforts to implement the Value-Based Compensation Initiative, which is planned to have broader participation than the Episodes of Care Program.

The Arkansas Blue Cross Episodes of Care program (which bundles payments for services associated with 12 condition-specific health episodes) initially was implemented in January 2013 as part of the Arkansas Healthcare Payment Improvement Initiative (AHCPII). The multi-payer program began as an effort to address broad variation in the efficiency of care provided within specific episodes - variation driven by multiple factors, including practice patterns and care settings.

Arkansas Blue Cross suspended the Episodes of Care program for the 12 episodes effective December 31, 2018. Reporting for the 2018 episodes continues throughout 2019. Other Arkansas Blue Cross value-based programs [Comprehensive Primary Care Initiative Plus (CPC+), Patient Centered Medical Home (PCMH) & Collaborative Health Initiatives] will remain operational.


Reimbursement programs