Anthem Blue Cross and Blue Shield in Ohio and TriHealth have demonstrated the significant benefits of value-based healthcare, announcing substantial improvements in preventive care and cost reduction for consumers in southwest Ohio. This positive outcome is a direct result of their collaborative value-based care agreement, initiated in 2014, showcasing the effectiveness of this healthcare model.
Consumers enrolled with Anthem and receiving care from TriHealth’s network of primary care physicians, specialists, and facilities have experienced a notable increase in preventive healthcare services. Key areas of improvement include higher rates of children’s annual checkups, enhanced diabetes testing and management, and increased vaccination rates.
“At Anthem, our core mission is to simplify healthcare, making it more affordable and accessible for everyone,” stated Steve Martenet, president of Anthem Blue Cross and Blue Shield in Ohio. “Our successful partnership with TriHealth clearly illustrates that high-quality care and cost efficiency are not mutually exclusive. This value-based model is crucial for proactively addressing health concerns before they escalate into emergencies. We are committed to leading the healthcare industry in fostering these types of collaborative partnerships with healthcare providers.”
The Anthem and TriHealth value-based healthcare program is strategically designed to empower primary care providers. By offering payment incentives, the program encourages proactive care coordination, comprehensive planning, and effective management of patient care. The 2017 data highlights the partnership’s success, revealing impressive results:
- Exceptional Childhood Immunization Rates: 93% of children received recommended immunizations.
- Strong Breast Cancer Screening Compliance: 79% of eligible women underwent breast cancer screenings.
- High Medication Adherence: 78% of patients adhered to their prescribed medication regimens.
- Improved Diabetic Complication Screening: 79% of diabetic patients received necessary complication screenings.
- Increased Well-Child Primary Care Visits: 74% of children received annual well-child visits, with specific age groups showing even higher engagement:
- Infants (under 15 months): 89% visit rate.
- Preschoolers (3-6 years): 90% visit rate.
- Adolescents (12-21 years): 67% visit rate, a traditionally challenging demographic for well-child visits.
According to Anthem’s data analysis, TriHealth’s performance in these metrics ranks at or above the 80th percentile among all Ohio health systems. This positions TriHealth as the leading health system within Anthem’s value-based health care program in Ohio. These achievements in preventive care and coordinated healthcare efforts have led to a significant reduction in the overall cost of care for Anthem consumers treated by TriHealth physicians. The Anthem and TriHealth partnership model ensures that a portion of these cost savings is reinvested back into TriHealth. This reinvestment supports further enhancements in primary care services, preventive health initiatives, and chronic disease management programs. The remaining cost savings are strategically utilized to mitigate health insurance premiums for Anthem consumers and employers, demonstrating a direct benefit to the community.
“TriHealth, along with our dedicated team of nearly 14,000 physicians, nurses, and healthcare professionals, is honored to be recognized by Anthem as the top-performing accountable care organization in Ohio and among the nation’s best,” stated Mark C. Clement, president and CEO of TriHealth. “At TriHealth, our unwavering commitment is to optimize healthcare for our community. We focus on the ‘Triple Aim’ of healthcare: enhancing population health, improving the patient care experience, and delivering greater value. This recognition from Anthem validates the significant progress we are making towards achieving these vital goals through anthem’s value-based health care program.”
