Anthem, So. Cal Hospitals Collaborate
In an apparent move to offer healthcare coverage to businesses at a lower price and with better integrated delivery of services, Anthem Blue Cross has teamed with Southern California's leading urban medical centers to create a new insurance product called Vivity.
The managed care plan includes many of the major acute care providers in the Los Angeles area, including Cedars-Sinai Medical Center, the UCLA Health system, Good Samaritan Hospital, Huntington Memorial Hospital in Pasadena and the five-hospital MemorialCare system in Long Beach and Orange County. The participating hospitals and Anthem will divide any profits derived from Vivity.
“This is an integrated health system and a very unique collaboration, the first time an insurer and seven competing quality hospitals have worked together,” said Pam Kehaly, Anthem Blue Cross of California’s president. She added that the collaboration was the result of three years of work.
CalPERS, the large benefits administrator for state employees and retirees, will be the first large group to offer coverage, officials said. Coverage in the Vivity plan will be limited to businesses with 50 or more employees until its growth curve is figured out, according to Kehaly. She noted at a press conference on Wednesday that premiums were “now lower than what exist today on the competitive market,” although she did not provide specifics. The Los Angeles Times suggested that they would be about 10% lower than the current market rates.
Kehaly also said that the participating hospitals and Anthem would share data on patients and coordinate care in order to reduce hospital readmissions and cut costs, particularly among those with chronic illnesses such as diabetes. However, she did not immediately offer any specifics.
Industry observers have suggested that Vivity is a play by both Anthem and the hospitals to counter Oakland-based Kaiser Permanente, which offers a truly integrated system of physicians, hospitals and medical specialties.
“There's been a decline in commercial HMO enrollment in the market, and this is a fight to take back volume from Kaiser,” said Steven T. Valentine, president of The Camden Group, an El Segundo-based healthcare consulting firm who is also a member of the Payers & Providers editorial board.
But Valentine was quick to note that networking a group of hospitals under a single name is not the same as what Kaiser has accomplished with a statewide network of hospitals and considerable brand equity. “Trying to get them economically aligned is going to be a bit of a challenge,” he said.
However, he added that the Vivity approach was the correct one to take.
“Just having a product like Kaiser is a win, but you have to internalize all the appropriate changes in for it to work,” Valentine said.
