Anthem ACOs Targeting Chronically-Ill PPO Population Improve Patient Health, Save $7.9 Million in 1 Year

Anthem Blue Cross (Anthem) announced today its Accountable Care Organizations (ACOs) under its Enhanced Personal Health Care Program, which targets PPO members with two or more chronic conditions to improve their overall health through enhanced care coordination, saved $7.9 million1 by improving total population health.

Medical group results are measured on an annual basis. Six of the 19 medical groups participating in Anthem’s ACO program produced these collective results during the same time period. The six medical groups are UC Davis, Sharp Rees-Stealy Medical Group, Sharp Community Medical Group, HealthCare Partners, Sante Community Physicians IPA and SeaView IPA.

“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.”

Across a variety of metrics including inpatient care, outpatient care, professional costs and pharmacy expenditures, there were indications of improved patient care.

Additionally, the pharmacy costs for Anthem’s ACOs increased, which is counterintuitively a positive outcome. Medical experts believe this change is due to higher drug adherence for those with chronic illness, leading to lower costs in other parts of the health system.