Anthem Blue Cross and Community Hospital of the Monterey Peninsula on Wednesday announced a new partnership to help patients dealing with complex medical issues.
The partnership is aimed at coordinating care between insurers and providers to make sure patients maintain prescriptions, receive necessary tests and treatment and find resources they may not otherwise know about. The hope is to keep chronic health issues such as diabetes from spiraling into a medical crisis.
“We’re managing people that have multiple medical problems who sometimes find it difficult to navigate the health care delivery system,” said Dr. Anthony Chavis, enterprise chief medical officer for Community Hospital Foundation.
With a fragmented health care delivery system, insurers often have access to more complete medical information than hospitals or clinics. But patients can be less likely to follow through on medical advice from their insurer than they are from doctors and nurses.
Anthem has been rolling out the program nationally over the past few years, and has signed 19 providers into the program, including operations in San Francisco, Santa Clara County, Santa Barbara County and more.
Community Hospital, which operates a hospital on Holman Highway, several outpatient facilities, laboratories, a mental health facility and a skilled nursing facility, officially joined the list in April.
Chavis said the programs work to not only improve health, but save money. Community Hospital, for example, pays for employee health care out of its own pocket, and has taken numerous steps to bolster the care employees receive in order to prevent costlier bills down to the road.
“We’ve been able to substantially control care costs,” Chavis said.
The partnership announced Wednesday targets patients with multiple medical issues, such as diabetes and depression, and fuses the medical information resources of Anthem with the bedside manner of Community Hospital doctors. Some Anthem group customers already receive similar attention through products negotiated by their employer.
Anthem said the coordinated care partnerships are paying off. The first six months of a partnership with Torrance-based HealthCare Partners produced $4.7 million in savings compared to a comparison group, the Indianapolis-based company said.
“From San Diego to Eureka, Anthem’s programs to coordinate patient care have proven to increase the quality of care and, therefore, lower costs,” said Brian Ternan, president of Anthem Blue Cross, in a statement. “We’re pleased to work with Community Hospital to bring this to Monterey County so we provide more coordinated care for Anthem’s PPO members.”
Date: May 27, 2015