Rewards and Recognition from Health Plans
Several major health insurers' pay-for-performance and recognition programs now reward and recognize diplomates who are enrolled in Maintenance of Certification and who regularly complete program activities such as ABIM PIMs Practice Improvement Modules®.
Active & Upcoming Health Plan Programs
If you have a contract with any of the health plans below, you may report completion of an ABIM PIM Practice Improvement Module® to a participating plan for recognition and/or reward. Please be certain you are in the health plan's network prior to transmitting your information.
- Blue Cross and/or Blue Shield Plans
- CIGNA HealthCare
- Upcoming Programs
- Recommend Programs
Aetna is now recognizing physicians who are committed to quality improvement and who have completed ABIM PIMs Practice Improvement Modules. Recognizing these physicians will help provide Aetna members with additional background to help them make informed decisions about their health care providers.
Specifically, Aetna will distinguish physicians who complete an ABIM PIM on DocFind®, the company's online provider directory. The physician's name on DocFind will be accompanied by a flag that states "Improving Practice Performance."
Aetna also will continue a program in place in certain areas of its Mid-Atlantic Region. The company will recognize participating primary care physicians (PCPs) who practice in southeastern Pennsylvania, southern New Jersey and Delaware who are enrolled in Maintenance of Certification (MOC) and who complete a Diabetes PIM. If you are enrolled in MOC and have completed a Diabetes PIM since January 2006, you may report this information to Aetna for recognition in the company's PCP Quality Enhancement (QE) program.
Visit DocFind at www.aetna.com/docfind.Top
Blue Cross and/or Blue Shield Plans
The Blue Cross and/or Blue Shield Association (BCBSA) and many regional Blue Cross and/or Blue Shield plans are offering recognition and/or reward for active participation in Maintenance of Certification. BCBSA will recognize any physician with a Blue Cross and/or Blue Shield contract in their national provider directory through the Blue National Transparency Initiative. Physicians contracting with a participating regional plan may be eligible to submit PIMs for additional recognition and/or reward. Follow the link below to view specific program and PIM reporting information for BCBSA and participating regional Blue plans. If your regional Blue Plan is not yet represented, you are still eligible to submit your PIM to BCBSA for recognition through the Blue National Transparency Initiative. Please check this site regularly for information on new and upcoming BCBS Plan programs. See participating Blue Cross / Blue Shield Plans.Top
CIGNA HealthCare incorporates completion of any ABIM PIM except the Self-Directed PIM into scoring criteria for its Physician Quality and Cost Efficiency Profile and CIGNA Care Network designation programs. Internal Medicine and Subspecialty Diplomates must be enrolled in Maintenance of Certification and complete one PIM at least once every two years. If you are contracted with CIGNA HealthCare, enrolled in Maintenance of Certification and have completed a PIM since January 1, 2006, you may report this information to CIGNA for inclusion in scoring for these programs. For more detailed program information please contact CIGNA provider services at 800-88CIGNA.Top
In order to assist Humana members in easily recognizing physicians who are participating in Maintenance of Certification, Humana is adding ABIM’s designated seal, "Improving Practice Performance," next to each physician’s name on the Physician Finder Plus tool on www.humana.com, which is available to Humana’s 11 million medical members. Recognizing Humana-contracted physicians who complete PIMs is consistent with Humana’s mission to guide members in making informed decisions about health care providers who are committed to improving their practices. Humana will recognize any ABIM diplomate for each PIM completed as of January 1, 2006, and will continue to post the designation for up to two years for each completed PIM. This distinction will become available on Humana’s Physician Finder Plus tool beginning August 1, 2007. For more detailed information or to determine if you are eligible for this program, please call your local Humana market medical officer or call Humana’s provider relations department at (800) 626-2741.Top
Internists and subspecialists with a UnitedHealthcare contract who are enrolled in Maintenance of Certification and complete a PIM will be recognized in UnitedHealthcare's online physician directory and UnitedHealthcare's other professional directories. Additionally, physicians who complete certain PIMs may be eligible for quality designation credit in UnitedHealthcare's Premium designation program in areas where the program is implemented. UnitedHealthcare will accept PIMs completed after May 2005.
For questions regarding the eligible PIMs or for more detailed information regarding the UnitedHealth Premium designation program, visit UnitedHealthcare Online or download a PDF of the program details.Top
Check this page frequently for information about upcoming plans.Top
Don't see your health plan listed? Send an e-mail to QualityImprovement@abim.org to recommend your health plan.