Anthem Blue Cross 2002 Annual Report Download - page 8

It began with a prominent physician in Columbus, Ohio, who wanted to find a better way
for doctors and health plans to work together to focus on health care quality. It became a
forerunner of what is now a national trend…basing physician reimbursement from health plans
in part on meeting measurable, mutually agreed upon quality goals.
The program involves MaternOhio—a cooperative that includes three physician practices
with 12 obstetrician/gynecologists—and Anthem Blue Cross and Blue Shield. The results are
simple: the physicians earn rewards for their quality efforts, and Anthem members receive
measurably better care.
“Part of this program is to demonstrate that physicians and health plans can be collaborative,”
says Mike D’Eramo, executive administrator of MaternOhio. “It helps in terms of lowering
tensions between doctors and health plans by proving we can do something positive together.”
D’Eramo credits the late Dr. William Copeland with originating the Columbus experiment.
The three practices that make up MaternOhio—Kingsdale Gynecologic Associates, Northeast
Obstetricians and Gynecologists, and Paraskos, Teteris and Diaz, M.D.s—together serve several
thousand Anthem Blue Cross and Blue Shield members.
Quality results are measured against the nationally recognized HEDIS威preventive care
measures and the standards of the American College of Gynecologists and Obstetricians. In
addition, the physicians are measured on patient satisfaction, obtained through questionnaires
given by the doctors to their patients and submitted to Anthem.
D’Eramo says part of the program’s success comes from Anthem’s willingness “to be open
minded.”
“This is not a big-dollar program,” D’Eramo says. “But it inspires the physicians. It gives
them something tangible to measure themselves against, and they like it because it is
entirely related to women’s health.”
MaternOhio
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