Enhanced Personal Health Care

WellPoint aims to strengthen the most important relationship in health care: the one between primary care doctors and their patients.

With Enhanced Personal Health Care, WellPoint has significantly increased its investment in the health of its patients. This effort also represents a major investment in primary care that will increase revenue opportunities for participating primary care physicians, enhance information sharing, and provide care management support from WellPoint clinical staff. In short, as the Wall Street Journal reported, WellPoint is, "putting a major investment behind the idea that spending more for better primary care can save money down the road." 

To participate, primary care practices must meet plan quality requirements, which include quality standards established by organizations such as the National Committee on Quality Assurance, the American Diabetes Association, the American Academy of Pediatrics and others. 

In addition to providing better health outcomes and higher quality health care for patients, this program could also help participating primary care practices earn 30 to 50 percent more than they earn today. Primary care physicians who maintain or improve quality will be able to earn revenue in three ways: 

  • General increase to the regular fees paid to physician practices for specific services.
  • Payment for additional services currently not reimbursed, with an initial focus on compensation for preparing care plans for patients with multiple and complex conditions.
  • Shared-saving payments for quality care and reduced medical costs.