As part of its commitment to quality and affordable health care in Colorado, Anthem Blue Cross and Blue Shield is now working under value-based arrangements that promote patient-centered care with more than one-third of the primary care providers across the state. Anthem launched Enhanced Personal Health Care in Colorado in early 2013 with some of its larger physician organizations, and since then has contracted under this new type of arrangement with more than 1,100 physicians from approximately 250 primary care practices, providing primary care services to more than 160,000 Anthem members. By the end of this year, Anthem’s goal is to contract with close to 50 percent of the state’s primary care physicians.
Enhanced Personal Health Care promotes patient-centered care and compensates providers for the work required to deliver this type of coordinated, personalized care. The aim of this new arrangement is better align incentives in order to bring high-quality care to patients and to control costs by promoting population health management. Anthem is making a major investment in primary care by moving to these value-based arrangements, and is also offering the support of a dedicated team of experts in patient-centered care who are devoted to helping providers succeed in adopting a patient-centered care model.
Primary care physicians who maintain or improve quality will be able to earn revenue in three ways:
Initial analysis found gross medical savings of $9.51 per attributed member per month (PaMPM) for members who saw EPHC providers compared to those who did not - a 3.3 percent reduction in medical costs.
5.1% PaMPM decrease in outpatient surgery costs*
Results showed an increase of 22.9 per 1,000 PCP visits for high-risk patients.*
*Based on overall program analysis, not Colorado-specific