Healthcare can be confusing. Who do you see for a certain problem? Where do you get the tests you need? Should you take a certain medication? A Primary Care Physician (PCP) can help.
Your regular doctor, or PCP, knows you and your health history, and can give you personalized advice. A PCP can treat routine illnesses and perform regular check-ups and screenings. He or she can also refer you to specialists and coordinate your care.
Learn more about choosing and using a PCP and requirements for metallic plan members.
At QualChoice, our goal is to make health insurance simple. And to do that, we’re helping PCPs make healthcare better. We’re working with healthcare providers, other insurance firms and state and federal groups to help PCPs move from volume-based care to value-based care.
Most healthcare is based on a fee-for-service model, where a set price is paid for the care given. The more tests and services, the more the doctor or hospital is paid. The quality of your care is not a factor.
With value-based care, payments to providers are partly based on the quality and efficiency of the care. Doctors are rewarded for working together, for providing the right care and for achieving positive outcomes.
QualChoice takes part in in these value-based care models:
Patient-Centered Medical Homes (PCMH)
At PCMH clinics, PCPs and healthcare teams work with patients to help coordinate their care with other providers outside the clinic. Learn more about PCMH.
Comprehensive Primary Care Plus (CPC+)
The QualChoice CPC+ program supports nearly 100 PCP practices in the state in providing quality primary care. Arkansas is one of 14 regions nationwide to take part in CPC+. Support for the program is supplied by the Centers for Medicare and Medicaid Services (CMS), health insurance firms and state Medicaid agencies. Learn more about CPC+ at CMS.gov or QualChoice.com.