BCBSMA To Require e-Prescribing To Qualify For Physician Incentive Programs

Blue Cross Blue Shield of Massachusetts (BCBSMA) said it is requiring physicians who prescribe medications to electronically prescribe to qualify for any of its physician incentive programs effective Jan. 1, 2011.

BCBSMA said it is introducing this initiative in an effort to continuously improve the quality, affordability and efficiency of care for its members. The new requirement applies to both primary care physicians and specialists. Currently, 99 percent of primary care physicians in the HMO Blue Network and 78 percent of specialists participate in BCBSMA incentive plans.

BCBSMA incentive programs reward physicians for meeting identified nationally recognized quality standards and patient safety goals. Prior to this requirement, e-prescribing was an optional incentive measure rather than an eligibility requirement for participating in BCBSMA incentive programs.

The new e-prescribing requirement comes one year before the Center for Medicare and Medicaid Services (CMS) deadline for prescribing without penalty.

Believing start-up costs continue to be a challenge for wide-spread adoption of e-prescribing, BCBSMA plans to help doctors by supporting a number of new licenses in 2009. This helps offset the wait for thee-prescribing incentive payouts from the CMS which begin in 2010.

According to John Fallon, chief physician executive, BCBSMA, "Our incentive programs are designed to reward doctors for taking steps to improve the quality of care for patients, and e-prescribing has certainly proven to increase quality of care."

BCBSMA said a recent patient safety study conducted by researchers at Dana-Farber Cancer Institute proved the impact of e-prescribing on adverse drug events. According to the study, it was estimated that the nearly 104,000 prescriptions changed by e-prescribing collaborative prescribers in 2007 prevented 724 potential adverse drug events, caused by potential drug-drug or drug-allergy interactions.

In addition to making healthcare safer, e-prescribing has an impact on reducing costs. The prevention of adverse drug events noted from the Dana Farber study above saved the healthcare system an estimated $630,000. At the patient level, through physician’s adhering to formularies, co-payments reduce. In 2006, physicians who used an e-prescribing device were able to choose more cost-efficient drugs and saved 5 percent on their drug costs relative to those prescribers who did not use this technology. Of that savings, BCBSMA members saved approximately $800,000 in co-payments associated with their prescriptions.

Seventy-one percent of e-prescribing collaborative prescribers said e-prescribing saves time for office staff with the majority saving one to two hours each day, BCBSMA said.

"With the primary care physician shortage, every additional moment doctors or their staff can dedicate to patients makes a difference," added Fallon.

Address: Blue Cross Blue Shield of Massachusetts, 401 Park Drive, Boston, MA 02115; (617) 246-5000, www.bluecrossma.com.