The Anthem Public Policy Institute was established to share data and insights to inform public policy and shape the health care programs of the future. The Public Policy Institute strives to be an objective and credible contributor to health care innovation and transformation through publication of policy-relevant data analysis, timely research, and insights from Anthem’s innovative programs.
Key Considerations for Transforming Quality Measurement and Reporting in Medicaid Managed Care
Nov - 2016
Quality measurement for Medicaid managed care organizations (MCOs) is at a crossroads. To date, states have had tremendous flexibility to design their quality measurement systems, including selecting metrics and setting benchmarks for MCOs’ performance that align with states’ priorities. But new federal regulations released by the Centers for Medicare & Medicaid Services (CMS) in April 2016 will impose greater consistency, requiring all states to develop a quality rating system that draws from a core set of measures and common methodology. Three new papers from the Anthem Public Policy Institute set out to examine the impact that quality rating systems have on individuals, health plans, and providers as well as highlight several areas for consideration on the future of quality rating systems.
- The “Nuts and Bolts” Behind Quality Measurement in Medicaid Managed Care
- Balancing Standardization and State Flexibility in Medicaid Quality Measurement and Reporting
- The Impact of Medicaid Quality Rating Systems on Consumer, Health Plan and Provider Behavior
Enhanced Consumer Engagement and Decision-Making Are Driving Better Health
July - 2016
Following the passage of the Affordable Care Act (ACA), states have taken different approaches to Medicaid reform and expansion. One state pursued Medicaid reform under its state-specific model by incorporating unique aspects such as personal responsibility and building on the success of its pre-ACA model. The Medicaid model uses program and benefit design, along with both financial and non-financial incentives, to drive consumer engagement and decision-making. A new white paper from Anthem's Public Policy Institute details promising initial results from this new model in Medicaid.
Early Results from the Enhanced Personal Health Care Program: Learning for the Movement to Value-Based Payment
Mar - 2016
The Enhanced Personal Health Care program was created to build upon the success of patient-centered and value-based care, which research has shown is capable of delivering higher quality and more affordable care for patients. A new report from the Anthem Public Policy Institute shares the company’s learnings from the early stages of this effort which includes partnerships with 54,000 providers serving more than 4.6 million patients as of the end of 2015.