The Enhanced Personal Health Care Program targets PPO members with two or more chronic conditions to improve their overall health through enhanced care coordination. Some methods the participating medical groups employed to improve the health of their members include standardizing care processes, coordinating transitions of care and using embedded care managers, social workers or personalized health teams.
Six of the 19 Californian medical groups participating in Anthem’s ACO program reported promising results between July 2013 and June 2014, with improvements across a variety of metrics including inpatient care, outpatient care, professional costs and pharmacy expenditures.
Here are some aggregated results from the six medical groups on metrics that changed under the program.
- Inpatient admits per 1,000 — decreased 7.1 percent (over the yearlong time period)
- Inpatient days per 1,000 — decreased 3.2 percent
- Outpatient admits per 1,000 — decreased 2.3 percent
- Outpatient days per 1,000 — decreased 2.2 percent
- Professional admits per 1,000 — decreased 2.5
- Professional days per 1,000 — decreased 2.6 percent
Additionally, the pharmacy costs for Anthem’s ACOs increased, which medical experts believe is due to higher drug adherence for those with chronic illness, leading to lower costs in other parts of the health system.
“Gone are the days when PPO members with multiple chronic conditions rarely receive team-based coordinated care,” said Brian Ternan, president of Anthem Blue Cross. “These results are further evidence that providing such care in the framework of an Anthem ACO does lower costs.”
To read more about how each medical group improved total population health or more program results, click here.
More articles on ACOs:
4 strategies BCBS used to save $1B through patient-centered programs
UnitedHealthcare, WakeMed Key Community Care launch accountable care partnership
The linchpin for ACOs? Data, experts say
