Anthem program rewards quality patient management

Anthem Blue Cross and Blue Shield’s Enhanced Personal Health Care (EPHC) program is being well received by local primary care physician (PCP) practices that are utilizing it.

The program empowers PCP practices to improve quality and outcomes and, subsequently, lower costs. Participating practitioners receive fee-for-service payments plus a monthly care coordination per member, per month (PMPM) payment.

The EPHC program came about after Anthem looked at the results of a three-year Citizens Health Initiative “Patient Centered Medical Home” pilot begun in 2008 with nine large PCP practices participating.

“We looked at this from all sides, and saw that, as a country, the problem with the health care model was it was volume versus value,” said Bob Noonan, vice president of provider solutions for N.H. Anthem BCBS.

Noonan said the Citizens Health Initiative showed an unprecedented improvement in clinical outcomes.

There were 33 percent fewer hospital admissions, 18 percent less emergency room visits and a nine percent reduction in re-admission rates.