Anthem Blue Cross ACOs realize $70M in savings


Anthem Blue Cross' various accountable care organizations appear to have produced considerable savings by leveraging data to coordinate care.

The Enhanced Personal Health Care Program equips providers with data on Anthem's PPO members with two or more chronic conditions. Applying predictive analytics lets the insurer work with providers to target members who were likely to need additional care and design treatments to avert health emergencies, Anthem Blue Cross President Brian Ternan said in an announcement.    

Together with its 17 ACO partners, Anthem Blue Cross accrued savings of $70.4 million over a 12-month period. The company calculated the savings by comparing ACOs' cost trends during the 12-month period to the previous 12 months, the announcement added.

Of the 17 medical groups that worked with Anthem, some improved on 10 of 13 nationally recognized quality metrics, including:

  • Twelve ACOs increased the percentage of patients who hemoglobin testing for diabetes patients.
  • Eleven groups reported that more children between ages 3 and 6 received one or more well-child visits with a primary care doctor.
  • Ten ACOs reported increases in the percentage of infants who reached the age of 15 months during the measurement year.
  • Nine of the medical groups reported that a higher percentage of sexually active women aged 16 to 24 were screened for Chlamydia.

Last year, Anthem Blue Cross reported $7.9 million in savings from ACOs. Further, ACO care managers have reduced emergency department visits and improved medication adherence rates significantly among members, UC Davis Health Systems’ Thomas Balsbaugh said previously.

Additionally, in first half of 2013, Anthem’s California-based PPO members experienced 4 percent lower hospital readmissions, an 18 percent decrease in hospital inpatient stays and a 4 percent reduction in lab tests ordered, according to a joint announcement with HealthCare Partners, an ACO that coordinates care for 55,000 PPO patients in California.