Health Plans
Several major health insurer's 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 PIMsm 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 PIMsm 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.
- Aetna Mid-Atlantic Region
- Blue Cross and/or Blue Shield Plans
- CIGNA HealthCare
- Health Alliance Plan
- Humana
- United Health Care
- Upcoming Programs
- Recommend Programs
Aetna Mid-Atlantic Region
Aetna Mid-Atlantic Region will recognize network primary care physicians practicing in the Delaware Valley (Southeastern PA, Southern NJ and Delaware) who are enrolled in Maintenance of Certification and complete a Diabetes PIM. If you are enrolled in Maintenance of Certification and have completed a Diabetes PIM since January 2006, you may report this information to Aetna for recognition in the PCP Quality Enhancement (QE) pay-for-performance program. For more detailed information or to determine if you are eligible for this program, please contact Aetna Provider Services at 800-624-0756 or visit www.aetna.com.
TopBlue 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 Distinction program. Physicians contracting with a regional plan may be eligible to submit PIMs for additional recognition and/or reward. If your regional plan is not yet represented, please submit your PIM to BCBSA for national recognition through Blue Distinction and check this site regularly for information on new and upcoming programs. See participating Blue Cross / Blue Shield Plans.
TopCIGNA HealthCare
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.
TopHealth Alliance Plan
Health Alliance Plan (HAP) will annually reward network internists (excluding those contracted with Henry Ford Health System) who are enrolled in Maintenance of Certification and have completed ABIM's Diabetes and/or Hypertension PIM since January 2006. For more detailed information read HAP Rewards Internal Medicine Physicians for Quality Improvement Initiatives located on Health Alliance Plan's website. To determine if you are eligible for this program, contact Health Alliance Plan's Provider Relations department at (800) 688-0040.
TopHumana
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.
TopUnitedHealthcare
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, call 1-866-270-5588, visit www.unitedhealthcareonline.com* or download a PDF of the program details.
*Click on "Clinician Resources," look for "Performance Measurement & Reporting," and click on "UnitedHealth Premium Designation Program."
TopUpcoming Programs
Check this page frequently for information about upcoming plans.
TopRecommend Programs
Don't see your health plan listed? Send an e-mail to QualityImprovement@abim.org to recommend your health plan.
