Press Releases

July 28, 2013

Anthem Blue Cross & Nine Providers Statewide Partner to Expand Enhanced Care Coordination Initiative

Contact: Darrel Ng
Anthem Blue Cross

Anthem Blue Cross (Anthem) announced today that it will expand its Accountable Care Organization (ACO) network to now include nine providers by July 1 to help those with two or more chronic conditions improve their overall health through enhanced care coordination.

“Research has shown that those with multiple chronic conditions have a lower quality of life and use a disproportionate share of medical care,” said Pam Kehaly, president of Anthem Blue Cross. “When care is coordinated for these patients through their doctor’s office, we’ve seen them get healthier and their corresponding health care costs have been reduced substantially. By expanding this improved coordinated care model statewide, an additional 200,000 Anthem members with these providers will be added to the program.”

Anthem led the way in patient-centered care with one of the first ACOs in the state. In 2013, Anthem continues to expand its ACO network across California, giving more members with multiple chronic health conditions support to improve their health with a personalized health team. 

“This is not your father’s Oldsmobile, but rather a fundamentally different way to treat patients,” said Dr. Michael Belman, medical director at Anthem Blue Cross. “Health plans are providing the data that doctors and their staffs need to target their resources toward the most vulnerable populations. We believe this approach will greatly contribute to slowing the increases in health care costs and improve the quality of care.”

As of July 2013, Anthem will have the following nine providers offering enhanced care coordination to members across California:

Cedars-Sinai Medical Care Foundation (Based in Beverly Hills, CA)*
HealthCare Partners Medical Group (Based in Torrance, CA)
Heritage Provider Network (Based in Northridge, CA)
Santé Community Physicians IPA Medical Group (Based in Fresno, CA)
SeaView IPA (Based in Oxnard, CA)
Sharp Community Medical Group (Based in San Diego, CA)
Sharp Rees-Stealy Medical Group (Based in San Diego, CA)
Torrance Memorial Medical Center/Torrance Memorial Integrated Physicians (Based in Torrance, CA)*
UC Davis Health System (Based in Sacramento, CA)

* Previously announced
Anthem expects to add additional providers in the coming months.

This new approach aims to help improve the health of members with chronic conditions. Through this model, members have access to a personalized health team which includes a physician, a care coordinator and other health care practitioners as needed. It is available to fully-insured PPO members. This program is expected to be available for self-insured clients in 2014.

Research has shown that a coordinated care approach to address chronic conditions has resulted in healthier, more satisfied and more productive employees. Results for the strategy, according to an Intensive Outpatient Care Program pilot study, 2009-2011, have been impressive, including significant reductions in hospital admissions, health care costs and missed workdays. The study also found participants had improved mental functioning, and many in the program reported that care was "received as soon as needed."

The enhanced care coordination model is part of an effort by Anthem and its affiliates to bring patient-centered care driven by value-based payments to every member in every one of our markets, and is part of our Patient Centered Primary Care initiative implementation in California.

What Our Partners Are Saying About the Program

"This expanded network complements the patient-centered and integrated care that UC Davis clinical teams have long delivered to patients. We're pleased to be part of this initiative because it enables us to be better engage individuals in their health, health care and overall well being."

- Ann Madden Rice, chief executive officer of UC Davis Medical Center in Sacramento

“Our physicians are excited to be part of this critically important enhanced care coordination program with Anthem. Our experience has convinced us that when patients are placed at the center of a team of providers dedicated to helping them manage their conditions and achieve their health goals, the results are impressive.”

- Daniel Bluestone, MD, medical director at Santé Community Physicians IPA Medical Group

“HealthCare Partners is committed to developing innovative models of healthcare delivery guided by the principles of quality and care coordination. Our enhanced care coordination enables us to apply these principles to Anthem members with two or more chronic conditions to improve their quality of life with a positive impact on healthcare costs.”

- Tom Paulsen, M.D., executive medical director, HealthCare Partners Medical Group

“Sharp Community Medical Group is proud to partner with Anthem in this innovative ACO project. Together, by focusing on our patients with complex or chronic illnesses, we can improve the patients’ quality of life, enhance their health care experience and lower overall health care costs for patients and employers. Intensive and targeted case management, ensuring comprehensive prevention efforts and engaging patients and families to become active participants in their own care are the “tools” of the new ACO that will achieve our goals.”

- Dr. John Jenrette, CEO of Sharp Community Medical Group

About Anthem Blue Cross:
Anthem Blue Cross is the trade name of Blue Cross of California. Anthem Blue Cross and Anthem Blue Cross Life and Health Insurance Company are independent licensees of the Blue Cross Association. ® ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross names and symbols are registered marks of the Blue Cross Association. Also follow us on Twitter at www.twitter.com/healthjoinin, on Facebook at www.facebook.com/HealthJoinIn, or visit our YouTube channel at www.youtube.com/healthjoinin.