Anthem Moves To Coordinate Care
Anthem Blue Cross of California is introducing a coordinated care program in conjunction with two Southern California providers.
Anthem, which termed the program an expansion of its efforts in creating accountable care organizations, will team up with two large Los Angeles-area medical groups: The Cedars-Sinai Medical Care Foundation and the Torrance Memorial Medical Center/Torrance Memorial Integrated Physicians. The intent is to improve the communications between provider and patient, making care more efficient and improving health.
Under the program, Anthem PPO enrollees with chronic conditions such as diabetes, asthma and high blood pressure will be assigned to a “personalized health team” that will include a physician, registered nurse and other medical professionals. The team will focus on eliminating duplicative tests for the patients, provide reminders for followup exams and immunizations, and provide close-in help during hospitalizations and discharges.
According to data from the Centers for Disease Control and Prevention, chronic conditions are quickly growing in both California and nationwide. For example, adult onset diabetes will affect about 10% of Californians by the end of the decade, up from less than 5% during the mid-1990s. The condition is associated with a variety of vexing medical conditions, such as heart attacks, blindness and loss of limbs. A recent study by UC San Francisco researchers also concluded that diabetics are the victims of debilitating pain, leading to many visits to hospital emergency rooms and hospitalizations.
“We know that members who are diagnosed with a chronic condition often face complex treatments and medical regimens, and are many times faced with figuring out how to navigate a very complex medical system on their own” said Anthem Blue Cross of California President Pam Kehaly. “By working collaboratively with our members and their medical team we can provide a coordinated health management approach that will help our members achieve better medical outcomes and ultimately better health overall.”
However, the current data is in conflict as to whether coordinated care programs will save the health system money. A study of coordinated care programs released by the Kaiser Family Foundation in October – including one undertaken in Southern California by the SCAN Health Plan – concluded that cost savings could be minimal. However, the report also noted there was not enough data available from current coordinated care programs to draw definitive conclusions.
Anthem projects that it will launch 20 more coordinated care programs with providers statewide in the coming months, although it did not provide specifics.
“There is much enthusiasm in the healthcare community for programs like this and we’re excited about the opportunity to work together with high quality partners in an innovative program directed to our PPO members in California,” said Michael Belman, M.D., Anthem Blue Cross's medical director.
