As part of its commitment to quality and affordable health care in
Indiana, Anthem Blue Cross and Blue Shield announced that it is now
working under value-based arrangements that promote patient-centered
care with 28 percent of the primary care doctors in Indiana.
Anthem launched the Enhanced Personal Health Care initiative in Indiana
in 2013, and since then has contracted under this new type of
arrangement with 1,400 physicians from 38 primary care practices that
provide primary care services to more than 325,000 Anthem members.
Enhanced Personal Health Care promotes patient-centered care and
compensates doctors for the work required to deliver this type of
coordinated, personalized care. The aim of this new arrangement is to
bring high-quality care to patients, and to control costs by promoting
preventive care, care coordination and chronic disease management.
"The biggest challenge in health care today is finding a way to improve
quality while reducing costs," said David Lee, M.D., vice president of
provider engagement and contracting for Anthem Blue Cross and Blue
Shield in Indiana. "We are making a major investment in primary care by
not only increasing revenue opportunities for participating physicians,
but by offering the support of a team of experts in patient-centered
care dedicated to helping the physicians adopt a successful
patient-centered care model."
Anthem's Enhanced Personal Health Care team is equipped with a full
suite of tools to share with doctors, so that everyone can have access
to helpful information and resources related to patient-centered care,
along with meaningful information about patients that allows doctors to
prioritize care management and target preventive care.
Patients who see participating physicians may see a range of benefits,
whether they are healthy or dealing with chronic diseases or acute
illnesses -- primarily more convenient access to care, and care that
takes into account the whole person and is personalized based on their
health history and preferences.
This type of care is supported by compensation for physicians that gives
them an opportunity to earn revenue in two ways:
• Monthly payments for care coordination - for example, preparing care
plans for patients with multiple and complex conditions, and exchanging
information with specialists, labs and with Anthem.
• An annual shared savings payment when high-quality care helps control
the growth of medical costs.
To participate in the shared savings aspect of the program, practices
must meet quality performance goals, which include quality standards
established by organizations such as the National Committee on Quality
Assurance, the American Diabetes Association, the American Academy of
Pediatrics and others.
Those primary care physicians, however, who maintain or improve quality
may earn up to 35 percent of the medical costs they save under the
shared savings model. Over time, Anthem estimates the program will
substantially improve quality and member health, as well as improve
overall medical costs as primary care practices transform themselves in
order to better manage the health of their patient populations.
Anthem Blue Cross and Blue Shield is the trade name of Anthem Insurance
Companies, Inc., an independent licensee of the Blue Cross and Blue
Shield Association. ® ANTHEM is a registered trademark of Anthem
Insurance Companies, Inc. The Blue Cross and Blue Shield names and
symbols are registered marks of the Blue Cross Blue Shield Association.
Additional information about Anthem Blue Cross and Blue Shield in
Indiana is available at www.anthem.com.
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