News & Commentary

Anthem Goes “All In” on Primary Care

February 19, 2016

Enhanced Personal Health Care Program

Research continues to suggest that comprehensive patient-centered care, delivered through Patient-Centered Medical Homes (PCMHs) or Accountable Care Organizations (ACOs), is capable of delivering better and more affordable care for patients.

After studying the results of these PCMH trials, Anthem created the Enhanced Personal Health Care Program to build on their success.

Anthem introduced the program with one simple principle: “primary care physicians and their practice team, provided with the right tools, information, and resources, are best equipped to optimize the health of their patients and improve the affordability of health care.”

With that in mind, the company’s aims for the program are to:

  • Make a significant investment in primary care;
  • Provide primary care physicians with tools, resources and information to promote access, shared decision making, proactive health management, coordinated delivery, adherence to evidence-based guidelines, and care planning built around individual patient needs;
  • Move from volume-based to value-based payment models; and
  • Improve the patient experience.

One area of the program showing early success is the group of ACOs, which saved $7.9 million from improving population health. Anthem credits team-based care for these cost savings. A report from the Patient-Centered Primary Care Collaborative notes several other impressive outcomes:

  • $130 million saved in 12 months
  • 3.5 percent lower ER costs
  • 2.3 percent increase in primary care visits for high-risk patients
  • 9.6 percent better in pediatric prevention
  • 4.3 percent better in diabetes care

Today, 54,000 primary care providers are part of Enhanced Personal Health Care, but the innovation continues with a Patient-Centered Specialty Care pilot program. This program is designed to promote a “medical neighborhood” model, developed by the American College of Physicians, which improves communication between primary and secondary providers and allows for effective co-management of patients.

Read more about the program from Anthem (PDF), or see a summary of the key details from the Patient-Centered Primary Care Collaborative.

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