The Choice is Yours with GIC Select & Save Plans; Methodology to Evolve for Quality Measures
With the GIC’s Select & Save health plans for employees and non-Medicare retirees, members save money by seeing higher performing physicians. Based on a thorough analysis of physician claims, GIC health plans assign physicians to tiers according to how they score on nationally-recognized measures of quality and cost efficiency. Members pay lower co-pays when they visit Tier 1 and Tier 2 physicians:
***Tier 1 (excellent) – lowest co-pay
**Tier 2 (good) – middle co-pay
*Tier 3 (standard) – highest co-pay
The GIC continues to work with physicians in and out of our health plans to refine physician scoring methodology. Some members of the medical community have expressed concerns that more quality measures for certain specialties are needed (due to the fact that some medical specialty societies have not devised enough quality measures), and that patient noncompliance should be factored into the scores. For FY 2010, the GIC will be using an advanced statistical model developed by a leading biostatistician at Johns Hopkins University that increases the probability that the quality scores are an accurate reflection of physician performance. The efficiency scoring methodology will remain unchanged for FY 2010.
Select & Save plans: pay lower office visit co-pays when you see higher performing physicians. Select & Save benefits do not apply to any of the GIC’s Medicare plans.
Oral arguments for and against the GIC's motion to dismiss the Massachusetts Medical Society's complaint about the CPI Initiative tiering methodology took place in Suffolk Superior Court in mid-December.
This information provided by the Group Insurance Commission.