WellCare Offers Incentives For The Patient-Centered Medical Home Model in Georgia

PCMH is a care delivery model in which a patient’s treatment is more effectively coordinated. The objective is to have a centralized setting that fosters partnerships between individual patients, their primary care physicians, and when appropriate, the patient’s family.

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WellCare Health Plans, Inc.
"This is an enhanced model of primary care that makes health care more accessible, comprehensive, coordinated and patient-focused,” said Dr. Sandra White, WellCare of Georgia Vice President and Senior Medical Director.

Tampa, Fla. (PRWEB) May 09, 2013

WellCare Health Plans, Inc. (NYSE: WCG) today announced a program to encourage the use of the patient-centered medical home (PCMH) model within its Georgia Medicaid provider network. As of March 31, 2013, WellCare served 573,000 Georgia residents who are enrolled in its Medicaid and PeachCare for Kids® programs.

The PCMH is a care delivery model in which a patient’s treatment is more effectively coordinated. The objective is to have a centralized setting that fosters partnerships between individual patients, their primary care physicians, and when appropriate, the patient’s family. Care is facilitated by registries, information technology, health information exchanges and other means to help ensure that patients get culturally- and linguistically-sensitive care when and where they need and want it.

“This is an enhanced model of primary care that makes health care more accessible, comprehensive, coordinated and patient-focused,” said Dr. Sandra White, WellCare of Georgia Vice President and Senior Medical director. “Support for the PCMH model has grown significantly within the U.S. health care delivery system, and for good reason. By fostering a strong physician-patient relationship that emphasizes proactive care coordination for all life stages, the PCMH can help to increase the quality of care, lower costs, reduce health disparities and achieve better health outcomes.”

WellCare is implementing enhanced payments for PCMH recognition and expanded services, and continuing pay-for-performance incentives for Georgia Medicaid providers that integrate this model into their physician practices.

“The PCMH supports our mission to enhance our members’ health and quality of life,” said Jesse Thomas, WellCare South Division President. “Practices will be incentivized to support and promote the delivery of high-value primary and preventive services, and will be rewarded for improved health outcomes while stabilizing or reducing total health care costs.”

The incentive program is based on the accreditation standards used by the National Committee for Quality Assurance (NCQA) to recognize the practice and/or the physicians as a PCMH. Practices are rewarded based on achieving three standards: establishment as a PCMH via NCQA accreditation, providing PCMH services such as enhanced access and care plan oversight, and meeting selected quality metrics.

For more information on the WellCare PCMH program, providers can contact their local WellCare provider representative or call the WellCare provider service line at 866-231-1821.

About WellCare Health Plans, Inc.
WellCare Health Plans, Inc. provides managed care services targeted to government-sponsored health care programs, focusing on Medicaid and Medicare. Headquartered in Tampa, Fla., WellCare offers a variety of health plans for families, children, and the aged, blind, and disabled, as well as prescription drug plans. The company serves approximately 2.7 million members nationwide as of March 31, 2013. For more information about WellCare, please visit the company's website at http://www.wellcare.com.


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