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Anthem Blue Cross ACO Generates Savings of $8 Million

By Doug Desjardins, California Healthfax  
   June 09, 2015

By focusing on members who have two or more chronic conditions, an Anthem Blue Cross ACO in California has been able to save almost $8 million by reducing incidences of hospital stays and outpatient visits, and increasing the use of generic prescription drugs.

An Anthem Blue Cross ACO focused on improving care for people with multiple chronic conditions generated nearly $8 million in cost savings over a one-year period.

The Enhanced Personal Health Care Program ACO involves Anthem PPO members who have two or more chronic conditions, such as diabetes, congestive heart failure, and asthma. Anthem said the program generated $7.9 million in savings among six medical groups by reducing the incidence of hospital stays and outpatient visits and increasing the use of generic prescription drugs. Anthem did not provide the total amount of money spent on patients taking part in the program.

"Gone are the days when PPO members with multiple chronic conditions rarely receive team-based coordinated care," said Anthem Blue Cross President Brian Ternan. "These results are further evidence that providing such care in the framework of an Anthem ACO does lower costs." The results were generated by approximately 200,000 participants during a one-year period from July 2013 to June 2014. The goal was to better coordinate care so that patients would better manage their conditions and improve their overall health.

Participants reported a 7.3% decline in hospital admissions per 1,000 patients, a 2.3% decline in outpatient visits per 1,000 patients, and a 4.2% increase in the use of generic prescription drugs. While 19 medical groups are taking part in the Enhanced Personal Health Care Program, the $7.9 million in savings was reported by six medical groups who started their programs around the same time. They include Sharp Rees-Stealy Medical Group, UC Davis, Sharp Community Medical Group, HealthCare Partners, Sante Community Physicians IPA, and SeaView IPA.

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