Anthem Blue Cross 2015 Annual Report Download - page 13

13Anthem 2015 Annual Report
In 2015, it became clear that this cancer quality initiative and payment model was taking hold with oncol-
ogists. Approximately two-thirds of patients with colon, breast and non-small cell lung cancer were
registered with the Cancer Care Quality Program, based on chemotherapy claims data and analysis from
HealthCore, our outcomes subsidiary. This figure increased to more than 78 percent when taking into
consideration those practices that had at least one patient registered with the program. Seventy-two
percent of registered patients with colon cancer were being treated with a therapy designated on path-
way and recommended by an Anthem plan as one of the regimens most likely to produce the best out-
comes, the fewest side effects and the most cost-effective care. For patients with breast cancer and
non-small cell lung cancer, in both cases 63 percent were on pathway.
Anthem is shifting the model of how our plans pay for cancer care and, in turn, improving the quality of
care. By reimbursing for treatment planning and care coordination, the link between drug margin and
practice revenue is weakened. The Cancer Care Quality Program resoundingly demonstrates that it is
possible to provide high-quality care while maintaining a level of affordability.
MEDICAID CAREMORE CARE CENTERS
Our plans’ goals are to improve health outcomes by taking into account the consumer’s complete health
profile and meeting his or her health care needs, no matter how complex. This can lead to improved
health care savings in the long term. CareMore’s nationally recognized clinical care model has been
highly successful in managing the Medicare patient population, and now CareMore is expanding its Care
Center model to serve the Medicaid population.
In Tennessee, on average, more than 70 percent of the Medicaid population is enrolled in some form
of managed care.1 In 2015, three CareMore Care Centers opened in Memphis to meet the needs of the
Medicaid population enrolled in an Amerigroup plan. CareMore Care Centers offer a holistic approach to
health and include everything from chronic condition care management to behavioral health support.
This care model ensures consumers are getting the necessary preventive and coordinated care to
Seventy-two percent of registered patients with colon cancer were being treated with a therapy
designated on pathway and recommended by an Anthem plan as one of the regimens most likely
to produce the best outcomes, the fewest side effects and the most cost-effective care.
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