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Insurers Reveal 2012 Roadmaps

Margaret Dick Tocknell, for HealthLeaders Media, March 7, 2012

In 2011 WellPoint launched it a value-based contracting initiative that links hospital payment increases to customer value. It introduced a similar program for physicians in 2012.

It has several ACO pilot and medical home programs that involve more than 100,000 members and more than $240 million in shared savings. The medical home program in Colorado posted an 18% decrease in acute inpatient admissions over the first 2 years and a 15% reduction in emergency room visits. In the first year of its ACO partnership with the Dartmouth-Hitchcock Medical Center in New Hampshire, inpatient admissions and avoidable ER visits declined.

WellPoint operates 29 CareMore care centers and expects to open several more this year to serve the acutely ill population.

The insurer's 2012 plan includes about $700 million of business investments, including medical management programs, payment reform models, and the IBM Watson initiative. Implementing ICD-10 will cost almost $100 million by itself. By the end of the year, WellPoint expects to have 96% of its membership on the platforms that will be ICD-10-compliant.

Margaret Dick Tocknell is a reporter/editor with HealthLeaders Media.
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