Premier Health and Anthem Blue Cross and Blue Shield in Ohio have entered into an agreement to provide value-based health care for their members and patients.
Value based health care is a fast-growing national model in which payment and reimbursement for health care services is based on the quality and cost of care. It differs from the traditional fee-for-service model, in which doctors and hospitals are paid based on the number of health care services they deliver.
Anthem’s Enhanced Personal Health Care model provides incentives for Premier Health doctors to lower costs while meeting quality measures set by the National Committee on Quality Assurance and recognized medical associations, such as the American Diabetes Association, American Academy of Pediatrics and others.
Both organizations will collect and analyze data on quality, costs and utilization allowing them to identify opportunities to improve care and lower costs.
“The shift toward a U.S. health care model that focuses on quality of care rather than volume of care is the foundation for improving care and reducing costs,” said Steve Martenet, president of Anthem Ohio. “Premier Health is one of the country’s most integrated and technologically advanced health systems — and a perfect partner for this kind of highly collaborative care model.”
The new arrangement includes Anthem’s employer-based, individual and Medicare Advantage members. Anthem is Ohio’s largest commercial health insurer with nearly 4 million members statewide.
“This agreement is based on a mutual goal to improve care and lower costs for the community members we serve,” said Mary Boosalis, president and CEO of Premier Health. “By working collaboratively with Anthem BlueCross and Blue Shield, with a focus on member (or patient) health rather than economics alone, we are confident that this will benefit the entire community.”
Premier Health, based in Dayton, is the largest health system in southwest Ohio with more than 14,000 employees, four member hospitals and 2,600 physicians in more than 70 specialties.