BCBSAZ Advances Payments to Medical Providers to Cover Shortfall due to Pandemic

Blue Cross Blue Shield of Arizona

Blue Cross Blue Shield of Arizona (BCBSAZ) announced a new program to support primary care providers (PCPs) across the state during the COVID-19 pandemic. PCPs participating in the BCBSAZ Patient Centered Medical Home (PCMH) program can now receive partial prepayment of their estimated annual quality incentive payment. These advances will help BCBSAZ PCMH providers cover monetary shortfalls due to this unprecedented global health emergency. This program supports healthcare providers with critical funding, so they can continue serving Arizonans in need of medical attention.

“Primary care providers across the state are dedicated to the health of their patients and communities, and we want to help them continue to treat their patients during the pandemic and beyond,” said Dr. James Napoli, chief medical officer at BCBSAZ. “These providers play a critical role every day in keeping our members healthy and have been greatly impacted as office visits have decreased. The prepayments will give them the flexibility they need to manage their operations in these uncertain times.”

More than 2,300 PCPs participate in BCBSAZ’s PCMH program, which promotes better communications and closer contact between patients and their provider. This value-based care program encourages PCPs to follow care plans focused on evidence-based standards for the management of key chronic diseases, and provider payments are linked directly to improved health outcomes rather than the volume of care. This results in patients who are healthier and more engaged, and healthcare practices that are more productive and efficient.

Qualified PCMH providers who meet criteria can opt-in by submitting an application and signing an agreement to participate in the advance payment program. BCBSAZ will make advance payments to the provider through a one-time payment that will be deducted from the providers end-of-year, quality incentive payment. Additionally, PCPs who are interested in joining the PCMH program and focusing on value-based care can participate with a signed PCMH amendment to their current network participation contract, and may then apply for prepayment support. More details can be found by contacting your provider representative or by emailing PCMHProgram@azblue.com.

This program is the latest in a series of steps BCBSAZ has taken to support healthcare providers, members and all Arizonans during the COVID-19 pandemic. BCBSAZ is providing financial assistance to organizations across the state to help increase testing and access to personal protective equipment, as well as those that help the most vulnerable Arizonans through food banks, homeless shelters, domestic violence facilities and other services.

Additionally, for members who receive care for COVID-19 related treatment from in-network providers, BCBSAZ has waived cost share on those services, as well as the need for prior authorizations. BCBSAZ also is covering medically necessary diagnostic tests related to COVID-19, and has eliminated cost sharing for telehealth video sessions, expanded hotline services, and increased access to prescription medications.

For more information about how BCBSAZ is supporting healthcare providers, members and the community during the COVID-19 pandemic, please visit azblue.com/coronavirus.

Blue Cross Blue Shield of Arizona (BCBSAZ) is committed to helping Arizonans get healthier faster and stay healthier longer. With a focus on connecting people with the care they need, BCBSAZ offers health insurance and related services to more than 1.7 million customers. Through advanced clinical programs and community outreach, BCBSAZ is inspiring health in Arizona. BCBSAZ, a not-for-profit company, is an independent licensee of the Blue Cross Blue Shield Association. The company, and its subsidiaries, employ more than 2,400 people in its Phoenix, Chandler, Flagstaff, and Tucson offices.

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