June 11, 2015
MONTEREY, Calif. – Anthem Blue Cross (Anthem) announced today that Community Hospital of the Monterey Peninsula has agreed to join Anthem’s coordinated care program, which targets members with two or more chronic conditions to improve their overall health through enhanced care coordination.
“From San Diego to Eureka, Anthem’s programs to coordinate patient care have proven to increase the quality of care and, therefore, lower costs,” said Brian Ternan, Anthem Blue Cross president. “We’re pleased to work with Community Hospital to bring this to Monterey County so we provide more coordinated care for Anthem’s PPO members.”
Fragmentation of the care delivery system is widely recognized as a cause of missed opportunities to treat both acute and chronic conditions. Coordinated care among physicians and other practitioners is essential to improved quality. Anthem is partnering with well-established providers in California, such as those at Community Hospital, to direct their extensive clinical resources into helping the PPO members who seek care with these groups.
“Community Hospital has been investing for years in resources to manage complex and chronic conditions across the continuum through its team at Community Health Innovations, and we are glad to partner with Anthem to offer these resources to our community,” said Steven J. Packer, MD, president/CEO of Community Hospital. “Our Community Health Innovations subsidiary has been instrumental in providing population health management, coordinated care, and evidence-based healthcare delivery. We are focused on wellness, on improving the health of our patients, and on promoting the well-being of our entire community. We look forward to working closely with our provider community to enable PPO members to maintain optimal health.”
Anthem’s initial partners showed across-the-board improvements in patient treatment in 2012, the first full year of Anthem’s program, including a 35 percent increase in the number of mammograms performed and a 44 percent increase in the appropriate prescribing of antibiotics for bronchitis. These results were achieved for PPO enrollees who have the freedom to see doctors outside the program. In contrast, other high-profile efforts are available only to the HMO population, which, by definition, already has coordinated care within a limited network. Updated financial and clinical results are expected to be released in the next month.
In addition to increased quality, Anthem’s work with HealthCare Partners produced $4.7 million in savings for the first six months of 2013 compared to a comparison group. These results were demonstrated by reduced hospital admissions and inpatient days, fewer emergency room visits, and reduced laboratory and radiology tests.
Anthem led the way in patient-centered care with one of the first coordinated care programs in the state in 2011, when it established programs with Sharp Community Medical Group, Sharp Rees-Stealy Medical Group, HealthCare Partners and Santa Clara County IPA. Anthem continues to expand the program across California, giving more members with multiple chronic health conditions support to improve their health with a personalized health team.
As of April 2015, Anthem has 19 providers offering coordinate care for those with multiple chronic conditions across California, including:
• Brown & Toland Physicians (Based in San Francisco, CA)
• Cedars-Sinai Medical Care Foundation (Based in Beverly Hills, CA)
• HealthCare Partners Medical Group (Based in Torrance, CA)
• Heritage Provider Network (Based in Northridge, CA)
• Hill Physicians Medical Group (Serving East Bay, San Francisco, Sacramento and San Joaquin. Based in San Ramon)
• Humboldt-Del Norte IPA (Based in Eureka, CA)
• MemorialCare Medical Foundation – MemorialCare Medical Group/Greater Newport Physicians (Based in Tustin and Newport Beach, CA)
• Sansum Clinic (Based in Santa Barbara, CA)
• Santa Clara County IPA (Based in Santa Clara, CA)
• Santé Community Physicians IPA Medical Group (Based in Fresno, CA)
• SeaView IPA (Based in Oxnard, CA)
• Sharp Community Medical Group (Based in San Diego, CA)
• Sharp Rees-Stealy Medical Group (Based in San Diego, CA)
• Sutter Health (including Palo Alto Medical Foundation, Mills Peninsula Medical Group, Sutter East Bay Medical Foundation & Sutter Pacific Medical Foundation. Based in Sacramento, CA)
• Torrance Memorial Medical Center/Torrance Memorial Integrated Physicians (Based in Torrance, CA)
• UC Davis Medical Group (Based in Sacramento, CA)
• UCLA Medical Group (Based in Los Angeles, CA)
• UCSF Medical Group (Based in San Francisco, CA)
Anthem will continue to seek additional providers to join its program.
The coordinated care program offers members access to a personalized health team which includes a physician, a care coordinator and other health care practitioners as needed. It is available to PPO members who meet program criteria.
Research has shown that a coordinated care approach to address chronic conditions has resulted in healthier, more satisfied and more productive employees. Results for the strategy, according to an Intensive Outpatient Care Program (IOCP) pilot study, 2009-2011, have been impressive, including significant reductions in hospital admissions, health care costs and missed workdays. The study also found participants had improved mental functioning, and many in the program reported that care was “received as soon as needed.”
About Anthem Blue Cross:
Anthem Blue Cross is the trade name of Blue Cross of California. Anthem Blue Cross and Anthem Blue Cross Life and Health Insurance Company are independent licensees of the Blue Cross Association. ® ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross names and symbols are registered marks of the Blue Cross Association. Also follow us on Twitter at www.twitter.com/healthjoinin, on Facebook at www.facebook.com/HealthJoinIn, or visit our YouTube channel at www.youtube.com/healthjoinin.