Value-based programs

Directory of value-based programs you are eligible for and their support pages.

Primary Care Reimagined | Hospital Value Model (HVM) | Episode of Care | California Advanced Primary Care Initiative (CAPCI) | Accountable Care Organizations (ACO)

Primary Care Reimagined

Primary Care Hybrid

The primary care pay-for-value hybrid payment model reimburses providers for services through a mix of traditional Fee-For-Service (FFS) and Per Member Per Month (PMPM) payments.

Primary Care Reimagined Support

Access program information, resources, and support materials.

Primary Care Hybrid value-based reporting

View member attribution and patient data about visits, risk scores and provider incentive opportunities.

Fee-For-Service Plus (FFS+)

FFS+ offers additional incentive payment for each attributed member based on your ability to meet targets for clinical quality, resource utilization, and patient experience metrics.

Primary Care FFS+ support

Access program information, resources, and support materials.

FFS+ value-based reporting

Find benefit details for Blue Shield IPAs, medical groups and their contracted providers.

Hospital Value Model (HVM)

The HVM program is a value-based payment model based on performance metrics for safety, utilization, and patient experience.

HVM support

Access program information, resources and support materials.

HVM reporting

View HVM reports with detailed information on financial and quality performance and potential opportunities.

Episode of Care (EOC)

EOC aims to transform how specialty health care services are delivered by shifting away from traditional fee-for-service (FFS) to value-based care in an episode of care arrangement

EOC support

Access program information, resources and support materials .

EOC reporting

View monitoring reports with detailed information on financial and quality performance and potentially opportunities.

California Advanced Primary Care Initiative (CAPCI)

EOC aims to transform how specialty health care services are delivered by shifting away from traditional fee-for-service (FFS) to value-based care in an episode of care arrangement

APC Payment Pilot (CAPCI)

California Advanced Primary Care Initiative reporting platform

Accountable Care Organizations (ACO)

EOC aims to transform how specialty health care services are delivered by shifting away from traditional fee-for-service (FFS) to value-based care in an episode of care arrangement

No value-based programs available

To learn about our value-based payment models and programs, contact carereimagined@blueshieldca.com.