Care coordination efforts initiated through Anthem's accountable care organizations (ACOs) saved four medical groups nearly $15 million over the course of one year, according to a post on the State of Reform website.
Anthem's Enhanced Personal Health Care Program (EPHC) targets unnecessary emergency department visits, drug costs and professional costs by providing medical groups with member-level data analytics targeting the group's sickest patients. Anthem pays a care coordination fee, allowing designated coordinators at each provider group to appropriately manage patients with comprehensive health problems.
For example, the Humbolt Independent Practice Association offers patients access to registered nurse care managers and wellness coaches who help them manage their chronic conditions and coordinate services throughout a variety of settings. At UCLA Health, care coordinators proactively target health concerns before patients require emergency care or a hospitalization. Together, Humbolt, UCLA, Torrance Memorial and Cedars-Sinai reduced inpatient admissions by 5.1 percent and reduced pharmacy costs by 6.5 percent, saving $14.8 million between 2013 and 2014, according to the post.
It's not the first time Anthem's EPHC program has been linked to significant cost savings. Last year, six other providers within the program saved $7.9 million, adding to $4.7 million in savings announced in 2014. A longtime proponent of ACOs, last month Anthem revealed a new partnership with Aurora Health Care in Wisconsin that would focus on reducing healthcare costs by steering members toward a select group of providers.
To learn more:
- read the State of Reform post
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