Anthem's year in review: 5 biggest stories from 2017

Indianapolis-based Anthem made headlines this year amid changes to its hospital imaging and emergency department policies and a C-suite shakeup.

Here are five of the most-read stories about Anthem this past year, as reported by Becker's Hospital Review.

1. Anthem changes coverage policy for MRIs, CT scans at hospitals
Anthem stopped covering outpatient MRIs and CT scans at hospitals without prior approval. The policy took effect July 1 in Indiana, Wisconsin, Missouri and Kentucky. On Sept. 1, the policy expanded into Ohio.

2. Physicians argue Anthem's ER policy violates federal law
Physicians are concerned about a new policy Anthem is rolling out in Indiana in January 2018. Under the new policy, which is already effective in three other states, Anthem will review diagnoses after members' emergency room visits. If the condition is determined to be nonemergent, Anthem may not cover the ER visit.

3. Hartford HealthCare sues Anthem over emergency services reimbursement arrangement
Hartford (Conn.) HealthCare Corp. sued Anthem Blue Cross and Blue Shield over allegations the insurer changed its emergency care reimbursement policies after the two failed to reach a provider agreement in October.

4. Anthem CEO Joseph Swedish to be replaced by former UnitedHealth executive
Gail K. Boudreaux was named president and CEO of  Anthem and appointed to the company's board of directors Nov. 20. She replaced Joseph Swedish, who will stay on as executive chairman of the board until May 2018 and then serve as senior adviser through May 2020.   

5. Anthem CEO Joe Swedish: 58% of business in alternative payment models
Fifty-eight percent of reimbursements from Anthem are linked to value-based care models, 75 percent of which are shared savings, shared risk and population-based payment models, former Anthem CEO Joseph Swedish said on a first-quarter earnings call in April.

More articles on payer issues:
Aetna's year in review: 5 biggest stories in 2017
UnitedHealth Group's year in review: 5 biggest stories in 2017
BCBS subsidiary to lay off 264 employees after losing 3-state Medicare contract

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