CareFirst wants to give discounts to members who choose efficient doctors

CareFirst BlueCross BlueShield knows which doctors are most efficient and soon you will, too.

The insurer plans to begin denoting in its physician directory which doctors are most efficient — those reducing unnecessary and costly tests, for example — possibly as soon as 2016. Members who chose those doctors could get a discount on their premium.

The doctor designation is one example of how CareFirst plans to begin using data collected as part of its successful Patient-Centered Medical Home program, which aims to slow rising health care costs. CareFirst is also considering waiving co-pays for some members, when the service is an integral part of their care plan, after learning through the PCMH program that about half of members don't follow their care plan.

"Where we're heading is towards ever greater incentives for efficiency, both to the member and to the provider," said CEO Chet Burrell.

Through the Patient-Centered Medical Home program, a group of doctors work together to treat patients with the goal of reducing unneeded tests and improving patients' overall health. If patients' health care costs come in under budget, the doctors share in some of CareFirst's savings.

CareFirst says the program has reduced annual cost growth from an average of 7.5 percent a year to 3.5 percent a year. That's about $1.2 billion in avoided health care costs.

After three years, CareFirst is about to cash in on another benefit of the program: a wealth of data about its doctors and patients. About 1.1 million of CareFirst's 3.4 million members are part of the Patient-Centered Medical Home. So are 4,100 — about 80 percent— of the network's primary care doctors.

Sarah covers health care, higher education, biotech and technology.