Anthem Blue Cross 2015 Annual Report Download - page 10

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10Anthem 2015 Annual Report
Since the program’s beginnings in 2012, participation has grown to 57,000 providers who care for 4.58
million members and have seen significant improvements in cost of care and patient experience. During
the first year of enrollment, we demonstrated a net savings of $130 million in the most recent analysis
of overall program impact. Overall costs for members in the program were 3.3 percent lower than
non-participating members, generating a savings of more than $9.51 per attributed member per month.
Participating providers performed better than non-participating peers
In our analysis of patient experience, cost savings stemmed from a variety of areas, including drops in
acute inpatient stays, with members attributed to a participating provider showing 7.8 percent fewer
acute inpatient admissions, fewer emergency room visits and lower spending on outpatient care, compared
to members whose providers were not participating. Utilization and cost data for members who saw par-
ticipating providers also showed 3.5 percent lower costs for emergency room visits. Not only are provid-
ers better managing their costs, more importantly they are better managing the health of consumers.
RESOLUTION HEALTH, INC.
Anthem subsidiary Resolution Health, Inc. (RHI) provides analytic solutions that play key roles in achiev-
ing the positive results we are seeing through Enhanced Personal Health Care as well as powering the
actionable alerts providers see on their care management system dashboards. While RHI analyzes claims
data, lab results and clinical results for more than 38 million affiliated health plans’ members, it also
specifically supports measures for more than 4.5 million health plan members and 57,000 providers par-
ticipating in the Enhanced Personal Health Care program. In 2015, RHI added 188 new clinical measures
that supported enhanced care gap identification and the expansion of physician scorecards to improve
overall patient and population health. For instance, one measure identifies patients between 18 and
75 years old who have diabetes and who had a retinal eye exam in the last two years. Diabetic retinopa-
thy is a highly specific vascular complication of both type 1 and type 2 diabetes and can lead to vision
loss.
9.6%
BETTER IN PEDIATRIC
PREVENTIVE CARE
4.8%
BETTER IN ANNUAL
MONITORING OF PER-
SISTENT MEDICATIONS
3.9%
BETTER IN OTHER
ACUTE AND CHRONIC
CARE MEASURES