CLEVELAND -- Anthem Blue Cross and Blue Shield in Ohio and the physicians of the Ohio Independent Collaborative announced today that they have launched a patient-centered arrangement for Anthem Medicare Advantage members designed to lower the cost of health care while improving overall quality. Anthem launched the Enhanced Personal Health Care primary care program in Ohio in early 2013, and since then has contracted under this new type of arrangement with thousands of health care providers across Ohio. This is the first major payer contract for OIC, which formed earlier this year. The agreement was effective January 1, 2016.
Enhanced Personal Health Care promotes patient-centered care and provides for value-based compensation to providers for the work required to deliver this type of coordinated, personalized care. The aim of this arrangement is to bring high-quality care to Anthem's Medicare Advantage members, and to control costs by promoting greater preventive care, enhanced care coordination and effective chronic disease management. Anthem is making a major investment in primary care by not only increasing revenue opportunities for participating providers, but by 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.
To participate in the shared savings aspect of the program, OIC physicians must meet quality performance goals, which include clinical quality measures as identified by the Centers for Medicare and Medicaid Services (CMS) that align with the Medicare Stars and the National Committee on Quality Assurance. Primary care physicians who maintain or improve quality, as well as optimize outcomes, may earn value-based incentive compensation through the shared savings model. Anthem's support of the OIC through this program will help promote the affiliated independent providers and their ability to pool resources and share best practices.
"This agreement with Anthem Blue Cross and Blue Shield serves as a testimony to the leadership of the Ohio Independent Collaborative as we continue to pave the way for independent physician collaboration and improved patient care," said Dr. Gary Pinta, president, OIC. "Our Anthem partnership allows us to offer lowered costs and improved quality to patients – it's a win-win."
"The OIC was founded on the belief that the best outcomes are born from strong partnerships, and this agreement with Anthem is another example of a partnership that is beneficial for everyone – including our patients," said Dr. Robert Kent, chairman, OIC. "We look forward to continuing this growing tradition of collaboration and leadership into the future."
"I am pleased that Anthem and OIC are working together to provide access to quality health care to the region," said Jim Pugliese, regional vice president of provider solutions for Anthem in northern Ohio. "Anthem is an industry leader in developing programs like this one that rewards quality care and ultimately reduces costs for consumers. OIC is an important partner and this initiative allows us to align our resources on programs that benefit our members and the community."
Anthem Medicare Advantage members who utilize OIC providers may see a range of benefits, whether they are healthy or dealing with chronic diseases or acute illnesses – with more convenient access to care, and care that takes into account the whole person and is personalized based on their health history and preferences.
About Ohio Independent Collaborative
Members of the Ohio Independent Collaborative collectively provide care for more than 900,000 patients, spanning the state from Columbus to Toledo, Sandusky, Cleveland and all markets in between. The coalition brings together nearly 800 primary care providers and specialists, who collaborate on initiatives that will improve clinical quality, patient care and access to providers. Members of the OIC include: Central Ohio Primary Care, Northern Ohio Medical Specialists (NOMS) Healthcare, Pioneer Physicians Network, Premier Physicians, The Toledo Clinic and Unity Health Network. To learn more about the Ohio Independent Collaborative, visit ohioindependentcollaborative.org.
About Anthem Blue Cross and Blue Shield
Anthem Blue Cross and Blue Shield is the trade name of Community Insurance Company, an independent licensee of the Blue Cross Blue Shield Association. ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. Additional information about Anthem Blue Cross and Blue Shield in Ohio is available at www.anthem.com. Also, follow us on Twitter at www.twitter.com/AskAnthem , on Facebook at www.facebook.com/AskAnthem.