Michael Belman, MD, medical director for payment innovation at Anthem, was encouraged by the results. "Unlike the HMO population, there isn't much of a history of coordinating and managing care among PPO members," said Belman. "Fortunately, many of the medical groups taking part in the program have been around for more than two decades and are very familiar with the HMO environment and managed care."
Anthem was also encouraged by the fact prescription spending declined 4.2%— due to a higher volume of generics—while the total number of prescriptions written by physicians increased. "That shows more patients are adhering to their prescription regimes and that physicians are writing more scripts for generic medications that work just as well as brand names," said Belman.
Medical groups participating in the program are provided with patient medical data and a care coordination fee from Anthem but are given leeway to craft their own coordinated care plans. Sharp Rees-Stealy medical director Steven Green, MD, said physicians their "employ telehealth visits, home visits, and remote monitoring" for patients while HealthCare Partners operates a separate ACO unit with a dedicated staff of care coordinators who track patients.
Gerald Kominski, director of the UCLA Center for Health Policy Research, said the results reported by Anthem are a sign that value-based care can produce results. "I find the results encouraging because they showed reductions in hospital IP [inpatient] days and stays, the most expensive component of care," said Kominski. "These are system changes that are long overdue, in my opinion, and indicate that healthcare providers are moving at a faster rate to adopt value-based care."