Anthem Blue Cross's accountable care organizations (ACOs), which are spread throughout California, saved $7.9 million in one year, the insurer announced.
The ACOs fall under the insurer's Enhanced Personal Health Care Program--which it launched last year to promote patient-centered care and compensate doctors for delivering coordinated, personalized care. It focuses on preferred provider organization (PPO) members with two or more chronic conditions.
Anthem gives each provider member-level data so they can better coordinate care for the sickest PPO patients. Each provider also receives a care coordination fee, which goes toward funding additional clinical care and coordination.
Of Anthem's 19 participating provider groups, six released collective results on inpatient care, outpatient care, professional costs and pharmacy costs.
UC Davis Health System, for instance, whose patients typically have kidney disease, asthma, heart disease and behavioral health issues "has reduced emergency department use, and our care managers have helped patients improve their adherence to medications," Thomas Balsbaugh, medical director for the Patient-Centered Medical Home program at UC Davis, said in the announcement.
SeaView utilized Anthem's ACO pharmacy analytics to relay member-specific utilization trends that have a possible generic alternative to providers, while Sante Health System used Anthem's care coordination money to fund social workers who helped patients with psychological issues.
Anthem experienced successful results soon after forming its ACOs. The insurer and HealthCare Partners saved $4.7 million during the first six months of 2013. The savings are notable because PPO patients can see doctors outside of the ACO. This is different from other ACO programs that cater toward the health maintenance organization population, FierceHealthPayer previously reported.
- here's the announcement