HAP Extends Payment for Colonoscopies to Eligible Family Physicians

Effective July 1, 2016, Health Alliance Plan (HAP) has expanded the list of physicians who are eligible to receive reimbursement for performing a colonoscopy to include contracted HAP/Alliance Health and Life Insurance Company (Alliance) Family Physicians at a contracted HAP/Alliance facility.

“Studies consistently show that Family Physicians are essential to creating value in healthcare,” said Robert Jackson, MD, MMM (Allen Park), MAFP President-elect and Chair of MAFP’s Task Force on Payment and Delivery System Reform. “This is particularly the case in performing diagnostic procedures, which can identify early stages of disease or illness, allowing prompt treatment with cost-effective measures within a Patient-Centered Medical Home.”

Reimbursing physicians commensurate with their documented training and/or experience, demonstrated abilities, and current competence and quality in performing screening and diagnostic colonoscopies prevents fragmentation of care, increases patients’ comfort and satisfaction, and decreases overall cost.

MAFP leadership believes that developing and nurturing ongoing relationships with health plans is essential to align Family Physician payment with the evidence-based value that Family Physicians have historically demonstrated, and to help design health benefit plans that raise the quality and value of healthcare.