Insurance company implements new payment model

OMAHA, Neb. -- Blue Cross and Blue Shield of Nebraska is partnering with McCook Clinic P.C. and nine other health care clinics on a new method of payment for doctors that is the first of its kind in Nebraska.

BCBSNE and the South East Rural Physician Alliance Accountable Care Organization, an affiliation of 10 independent Nebraska clinics, have signed what's known as a "Total Cost of Care" payment contract. Total Cost of Care is a standardized approach that measures the cost of medical care--including inpatient, outpatient, professional, pharmacy and ancillary services.

In this innovative model, physicians are rewarded financially if they perform better than projected on patient experience, outcomes and costs; and they share in the financial risk when their patient results are less favorable than expected.

BCBSNE is the first commercial health insurance company in Nebraska to implement this type of provider payment method. The TCC contract with SERPA-ACO goes into effect July 1, 2014.

"This agreement with SERPA-ACO supports our belief in the critical role of the primary care physician in a patient's health care," said Lee Handke, BCBSNE senior vice president. "Studies have shown that the stronger a patient's ties to his or her primary care physician, the better the quality of care received, and the more efficiently that care is delivered."

SERPA-ACO includes McCook Clinic and others in Bellevue, Broken Bow, David City, Geneva, Hastings, Kearney, Lexington, York and Lincoln.