Anthem, Inc. is committed to being a valued health care partner and working together to transform health care with trusted and caring solutions. We advocate healthy living, and our affiliated health plans provide consumers with tools and information to better manage their health, work with health care providers to help keep chronic conditions under control, and bring health care and coverage to medically underserved communities.
Highlights of our programs designed to help fulfill our mission include:
Enhanced Personal Health Care
Patient Safety First
The collaborative’s mission is to improve quality and reduce health care costs across the state. Since the inception of the collaborative in 2010, PSF member hospitals have shown significant improvement in four important hospital-based avoidable harm initiatives: sepsis mortality, ventilator associated pneumonia, central line blood stream infections and perinatal gestational age deliveries under 39 weeks.
- 74 percent reduction in early elective deliveries prior to 39 weeks gestational age
- 57 percent reduction in cases of ventilator associated pneumonia
- 43 percent reduction in cases of central line blood stream Infections
- 26 percent reduction in sepsis mortality
Quick Care Options Program
- An educational site explaining when it's appropriate to use ER alternatives, such as retail health clinics and urgent care centers.
- A Google map, available to everyone, that provides the location of ER alternatives in the state so that consumers can easily find them.
- Automated calls to educate members, and e-mails to members interested in learning more information.
- Educational pieces mailed explaining the type of conditions that could be treated at ER alternatives and potential differences in cost.
The study showed that ER use for conditions that could be treated at retail health or urgent care clinics decreased in 2010 from 2009 for all populations studied. Specifically, the study reported a 14 percent decrease in non-emergency ER visits for those who participated in the program compared with those who did not. The decrease in visits covered minor sicknesses or conditions that could be treated elsewhere.
Disease Management Programs
Chronic disease is the number one cause of death, disability and rising health care costs in the United States. Our affiliated health plans work with providers to help members better manage chronic conditions, such as heart disease, diabetes and asthma, and others. By preventing a chronic illness from becoming worse, members can experience a better quality of life.
Anthem, Inc.’s affiliated health plans offer disease management programs that use personalized interventions based on clinical, evidence-based guidelines that support members in following their doctor's care plan and reaching their health goals. Nurse coaches work with members to help them become more educated about their health and what they can do to improve it.
Under a unique collaboration, the National Council on Aging with support from the Bristol-Myers Squibb Foundation and Anthem companies are—for the first time—bringing a proven and affordable face-to-face and online support program to help people manage their Type 2 diabetes.
Better Choices, Better Health® --Diabetes is an evidence-based program developed by Stanford University and has been scientifically proven to help individuals manage their diabetes and improve their health.
The six-week workshop is taught by trained peer leaders, many of whom have diabetes themselves and easily accessible online or through an in-person workshop. Together, workshop participants learn about their condition and set realistic and measurable goals to improve health. They discover tips and tools to help them monitor their blood sugar, food, medication, and exercise; create and track a weekly action plan; discuss problems they’re facing; and celebrate successes.
Workshop participants may also be able to participate in a research study of the pilot program, which will determine if participants see real improvement in their health. Measurements of success will be monitored by lab tests of HbA1c results, self-reported questionnaires based on how members feel, and/or claims data that can track members’ use of health care services and their costs.
The results may help health plans determine if they should offer the program as a standard benefit. Stanford and Anthem, Inc.’s health outcomes and clinical research affiliate, are leading the evaluation efforts.
- American College of Cardiology (ACC)
- Institute for Healthcare Improvement (IHI)
- National Quality Forum (NQF)
- The Joint Commission (JC)
- The Society of Thoracic Surgeons (STS)
Cancer Care Quality Program
Anthem, Inc. companies have introduced an innovative quality initiative that will allow oncologists to compare planned cancer treatment regimens against evidence-based clinical criteria and potentially receive enhanced reimbursement.
The Cancer Care Quality Program identifies certain cancer treatment pathways selected based upon current medical evidence, peer-reviewed published literature, consensus guidelines, and Anthem, Inc.’s clinical policies, to support oncologists in identifying cancer treatment therapies that are highly effective and provide greater value.
Today, cancer care is challenged by the following:
- Up to 1 in 3 people treated with chemotherapy do not receive a treatment plan that is consistent with current medical evidence and best practices.
- Costs of new cancer therapies are growing by 25 percent annually.
- As many as 180 medical journals publish new studies on cancer monthly and quarterly, making it difficult for oncologists to stay up-to-date.
- Cancer drugs – unlike other therapies – are purchased directly by practices and hospitals from manufacturers or distributers. Health insurers generally reimburse practices a set percentage above the cost of the drug.