Explanation of Blue Cross PPO – HMO, Networks, etc. options
from their official brochures.
Preferred Provider Organization (PPO)
Health Maintenance Organization (HMO)
Optional PCP Selection can help improve employees’ health and lower costs
A strong relationship between your employees and a primary care physician (PCP) is important to promoting wellness, improving health and reducing costs. Optional PCP Selection lets your employees choose a PCP.
Optional PCP Selection helps members strengthen relationships with their doctors
We are moving from volume-based to value-based payment models, rewarding doctors when they improve patient health and affordability. That focus can be seen in our collaboration with doctors and in our payment innovation programs, like Enhanced Personal Health Care (EPHC), known nationally as Blue Distinction Total Care. Through the EPHC approach, members get the right level of care from the doctor that’s best for them, at the right time. It focuses on the quality of care doctors give, not the number of patients they see.
Why designate a PCP?
When members choose an EPHC doctor from their health plan as a PCP, they’re helping us help them. We can keep their doctors in the loop when they have an ER or hospital visit. We can reach out to that doctor about tests and services a member may need. We also can share other resources that will help doctors emphasize wellness with members. The goal is to have everyone work together so a member’s overall care makes the best sense. And when employees choose an EPHC doctor as their PCP, that doctor can more quickly take over the responsibility of coordinating the member’s care.
Encourage your employees to designate a PCP
Developing a relationship with a PCP is all about improving health care quality, outcomes and affordability. That’s why we’re encouraging members in open access plans to designate a PCP as part of the Optional PCP Selection on anthem.com/ca. They also can call customer service or have you, their employer, complete the selection through Employer Access.
To know more about Optional PCP Selection, read our Frequently Asked Questions. And if you have any more questions or want to know if Optional PCP Selection is right for your company, talk to your account representative. Optional PCP Selection is not available to members who reside in Virginia or who wish to select a PCP in Virginia and is not planned for use in attribution outside of our core service area for the foreseeable future.