|[March 25, 2014]
32 Percent of Anthem Blue Cross and Blue Shield in Ohio Primary Care Providers Working Under New Payment and Care Coordination Arrangement in 2014
MASON, Ohio --(Business Wire)--
As part of its commitment to quality and affordable health care in Ohio,
Anthem Blue Cross and Blue Shield announced that it is now working under
value-based arrangements that promote patient-centered care with 32
percent of the primary care providers across the state.
Anthem, which serves more than 3.3 million members, launched Enhanced
Personal Health Care in Ohio January 1, 2013, and since then has
contracted under this new type of arrangement with 2,070 physicians from
131 primary care practices across Ohio.
Enhanced Personal Health Care promotes patient-centered care and
compensates providers for the work required to deliver this type of
coordinated, personalized care. The aim of this arrangement is to bring
high-quality care to patients, and to control costs by promoting greater
preventive care, enhanced care coordination and effective chronic
Anthem is making a major investment in primary care by not only
increasing revenue opportunities for participating providers, but by
offering the support of a dedicated team of experts in patient-centered
care who are devoted to helping providers succeed in adopting a
patient-centered care model.
Anthem's Enhanced Personal Health Care team is equipped with a full
suite of tools and sophisticated reporting to share with providers that
allow providers to better address gaps in care, and prioritize overall
"With so much change in our industry today, one thing that remains
constant is taking steps to advance the quality and affordability of
health care. We know that the physician-patient relationship is the most
important one in promoting health and wellness," said Dr. Barry
Malinowski, Vice President and Medical Director for Anthem in Ohio.
"Thanks to ths program, primary care physicians have the necessary
resources, along with the financial incentive, to begin maximizing the
potential of primary care to help our members live healthier lives,
while responsibly reducing costs."
Patients who see participating providers may see a range of benefits,
whether they are healthy or dealing with chronic diseases or acute
illnesses - with 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. Primary care physicians who maintain or improve
quality may earn up to 35 percent more than they earn today through 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 and needs of their patient populations.
About Anthem Blue Cross and Blue Shield in Ohio
Anthem Blue Cross and Blue Shield is the trade name of Community
Insurance Company, an independent licensee of the Blue Cross 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 and Blue Shield
Association. Additional information about Anthem Blue Cross and Blue
Shield in Ohio is available at www.anthem.com.
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