According to recent studies, the treatment for the top one percent of
patients with chronic conditions accounts for 25 percent of all health
care spending by the privately insured. Between multiple hospital stays,
emergency room visits and prescription drugs, medical spending for this
group can quickly add up to hundreds of thousands of dollars. Physicians
and medical experts agree that a collaborative and coordinated approach
to treat chronic conditions is key to successfully improving the health
and wellness of patients while also helping to address the growing costs
associated with treatment.
Anthem Blue Cross led the way in patient centered care with one of the
first Accountable Care Organization (ACO) in the state. Beginning this
month, Anthem is expanding this model and network with the introduction
of a program focused on enhanced care coordination in collaboration with
well organized, high quality provider organizations in California. This
program is specifically designed to help improve the health of members
affected by chronic conditions and improve the value of the care
delivered. The new program will be available to fully insured PPO
members at no additional cost, with self-funded offerings to follow.
For members who reside in Southern California, the new program is
available at Cedars-Sinai Medical Care Foundation and Torrance Memorial
Medical Center/Torrance Memorial Integrated Physicians. Anthem will be
expanding the program to more than 20 providers in coming months.
Anthem's program focused on enhanced care coordination emphasizes
coordinated, evidenced-based care delivered by a health care team
focused on members who suffer from multiple chronic conditions such as
diabetes, asthma, high blood pressure as well asheart and joint
diseases. Members will have access to a personalized health team which
includes a physician, a registered nurse and other healthcare
practitioners as needed.
Together, this team will coordinate a member's care based on their
unique needs and will help guide them through the most effective and
efficient care possible by eliminating duplicative procedures, providing
reminders for follow-up examinations and immunizations and managing
emergency room and hospitalization follow up.
"We know that members who are diagnosed with a chronic condition often
face complex treatments and medical regimens, and are many times faced
with figuring out how to navigate a very complex medical system on their
own" said Pam Kehaly, president of Anthem Blue Cross. "By working
collaboratively with our members and their medical team we can provide a
coordinated health management approach that will help our members
achieve better medical outcomes and ultimately better health overall."
In fact, research has shown that a coordinated care approach to address
chronic conditions has resulted in healthier, more satisfied and
productive employees. "These types of results have really highlighted
the value that can be achieved by working collaboratively," explained
Michael Belman, MD, medical director for Anthem Blue Cross. "There is
much enthusiasm in the health care community for programs like this and
we're excited about the opportunity to work together with high quality
partners on an innovative program directed to our PPO members in
California," added Dr. Belman.
This latest expansion adds to Anthem's existing ACO network which
includes Sharp Community Medical Group, Sharp Rees-Stealy Medical
Centers, Santa Clara County Individual Practice Association and
HealthCare Partners Medical Group.
About Anthem Blue Cross:
Anthem Blue Cross is the trade name of Blue Cross of California. Anthem
Blue Cross and Anthem Blue Cross Life and Health Insurance Company are
independent licensees of the Blue Cross Association. ® ANTHEM is a
registered trademark of Anthem Insurance Companies, Inc. The Blue Cross
name and symbol are registered marks of the Blue Cross Association.
Additional information about Anthem Blue Cross and Anthem Blue Cross
Life and Health Insurance Company is available at www.anthem.com.
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