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Innovations at Anthem, Inc.

Anthem, Inc. is committed to delivering the best combination of health, care and value in the industry, and to finding new and improved ways to provide real-world solutions that simplify health care processes and improve health care quality. 

LiveHealth Online

Consumers now have a fast, more convenient way to see a doctor for non-emergency needs when their own doctor is not readily available.
 
Consumers can now use their smart phone, tablet or computer to have a live video visit with a board certified doctor of their choice to discuss non-emergency health issues from home, work or wherever they happen to be as long as they have a wi-fi signal or Internet access.
 
This new online care service, LiveHealth Online, launched in 2013 with doctors available 24 hours, 365 days a year, including holidays.
 
Consumers  can also use LiveHealth Online, simply by registering and paying for the visit with a credit card.  Doctors using LiveHealth Online charge $49 per visit.

IBM Watson 

Our company and IBM announced an agreement to create the first commercial applications that utilize IBM Watson technology to help improve the delivery of quality, evidence-based health care. IBM Watson has the ability to analyze the meaning and context of natural language, and rapidly process information to find precise responses to questions.

In recent years, few areas have advanced as rapidly as health care. For physicians, incorporating hundreds of thousands of articles into practice and applying them to patient care is a significant challenge. IBM Watson can sift through an equivalent of about 1 million books or roughly 200 million pages of data, and analyze this information to provide precise responses in less than three seconds. This capability is expected to enable physicians to engage IBM Watson to coordinate medical data programmed into Watson with specific patient factors, to help medical professionals identify the most likely treatment options and perhaps refine diagnoses in complex cases.

Plain Language

There is no rule that health care has to be confusing. Yet all too often, instructions and paperwork are issued using language that complicates rather than clarifies. According to the National Assessment of Adult Literacy, 50 percent of American adults (93 million people) have trouble understanding and using health information, and two out of three people don’t understand their health insurance coverage. The result of this confusion is that Americans make uninformed health care decisions, get fewer preventive screenings and have higher health care costs.
 
To address this problem, Anthem, Inc. created its Plain Language program – a commitment to communicate clearly, not only with members, but also with employers, brokers and within the company itself.
 
Clear communication requires an ongoing commitment, but the principles guiding the Plain Language program have achieved some early successes. Specifically, Anthem companies have developed MyHealth Note – an explanation of health benefits that uses everyday words rather than legalese. Since MyHealth note was created in 2009, it has resulted in 50 percent fewer health plan member complaints, a 13 percent increase in people who rated MyHealth Note as “a trusted resource,” and a 12 percent increase in people who said the tool helped improve their overall health.

Availity

Simplification is at the heart of innovation.  In health care, that means streamlining administrative processes so doctors can focus on providing care rather than filling out paperwork.  To accomplish this, Anthem, Inc. selected Availity, LLC as a strategic part of its suite of online provider solutions.
 
Availity offers a secure multi-plan portal at no charge to doctors and other providers to improve efficiencies in the healthcare system by simplifying many aspects of health plan administration – an important step toward advancing affordable patient care. Now, instead of having to access different reimbursement systems for each insurer, providers can use the Availity multi-plan portal and have access to a common claims interface for all participating health plans.  Availity’s "one-stop-shop" approach benefits patients, providers and health plans by streamlining the health care administration process and providing a consistent user experience.
 

Estimate Your Costs

Anthem, Inc. companies have been industry leaders in the transparency space since 2006, when our Estimate Your Costs tool was developed. It is an online transparency tool and resource that provides cost information at specified area hospitals for common procedures such as MRIs and CT scans and other surgical procedures. Estimate Your Costs puts helpful information at health plan members’ fingertips, allowing them to quickly and easily compare prices across facilities.

Patient Reviews of Their Doctors

Hearing what people have to say about their doctors may help others choose one that's right for them. That's why a few years ago Anthem, Inc. became the first health benefits company to make doctor ratings and reviews available on our affiliated health plan member websites.
 
Today, enhanced ratings and review tools give affiliated health plan members access to more than 500,000 reviews of doctors across the country. It’s built right into the Find a Doctor search tool and uses a star-rating system — so reviews can be created quickly and it’s simple to read them.
 
It’s an important part of our effort to provide affiliated health plan members with innovative tools to help them find health care that’s right for them.

Managed Care Pharmacy Resident Program

The Anthem, Inc. Managed Care Pharmacy Resident Program is designed to help pharmacy graduates transition from the academic setting to one that fosters an exceptional drug-management experience.
 
The program achieves this by providing practical and comprehensive exposure in all components of managed-care pharmacy practice. Participants in the program interact with health care providers who assist our health plan members and coordinate member care with nurses, social workers, pharmacists and medical directors in our health plans.
 
We are proud that our program recently received a six-year, full accreditation from the American Society of Health-System Pharmacists and Academy of Managed Care Pharmacy (AMCP). Additionally, the program has been acknowledged by the professional pharmacy community for its senior leadership support, interdisciplinary approach, growth potential, clear and concise experiential documentation and other innovative strides.

Reference Based Pricing

Wide price variations often exist for the same health care services, even within the same geography and same network. However, higher prices do not necessarily correspond to better quality care. This creates an opportunity to reduce costs without sacrificing quality. With Reference Based Benefits, employers can set a benefit limit, or "reference price" for specific types of services covered under their group health plans administered by Anthem, Inc.'s affiliated health plans. Using consumer-friendly tools provided through a collaboration with Castlight employees covered by Anthem, Inc.’s affiliated health plans can easily find high-quality providers that provide the services for a fee that is at or below the reference price.
 
Reference Based Benefits are highly configurable based upon an employer's needs. They can be dynamically tailored to each specific company in each of its geographies, including variations in which services are included in the program and the reference price for each.

CalPERS Reference Based Pricing Pilot

A pilot program for the California Public Employees’ Retirement System lowered the price of members’ hip and knee replacement surgeries by 19 percent in one year while also demonstrating similar to better outcomes at lower-cost hospitals.

The analysis is based on findings for the referenced-based purchasing design program for CalPERS members developed by CalPERS and Anthem, Inc.’s affiliated health plan in California.  

California hospital charges for total knee replacement and total hip replacement surgeries ranged from $15,000 to $110,000 without evidence of difference in outcome or quality, according to Anthem, Inc.’s California affiliated health plan analysis conducted in 2009.


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