Blue Shield launches new “episode of care” payment model

October 03, 2022

Blue Shield of California is launching a new value-based, shared savings payment model for specialty care physician practices. The program aims to transform how specialty care services are delivered by shifting away from traditional fee-for-service to value-based care in an “episode of care” arrangement. The focus of an episode of care arrangement is providing coordinated, collaborative care across the health care continuum to help ensure patients receive the highest quality care while managing costs.

Practices who join the program would have direct financial incentives via shared savings for improved outcomes for specialty services, with no downside financial risk to the practice. Blue Shield is initially launching the program for orthopedic, maternity and gastroenterology services, with intentions to expand to other specialties in the future.

To qualify for the program, you must participate in the Blue Shield commercial PPO network.

To help physicians understand the new payment model, Blue Shield has published a series of on-demand webinars. 

Blue Shield encourages interested physicians to watch one of the above webinars, and then join a live Q&A session to have your questions answered:

To request more information, including access to detailed operations guides, please email carereimagined@blueshieldca.com.

Also see: CMA webinar to look at the future of primary care in California


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