Anthem and SVHP to collaborate on new model of provider reimbursement

Anthem Blue Cross and Blue Shield and St. Vincent's Health Partners (SVHP), Inc., announced today the collaboration on a new model of provider reimbursement. Under this new arrangement, SVHP will focus on the management of chronic disease and preventive health of their patients.

“Unlike traditional physician-hospital relationships, which are often inefficient and can result in fragmented patient care, SVHP plans to align physician and hospital efforts through active coordination of care and data sharing”

In moving to a patient-centered accountable care model, Anthem and SVHP, a Physician Hospital Organization in Bridgeport, have agreed on quality metrics on hypertension, diabetes, management of tobacco use and identifying obesity, in addition to industry standard primary care based metrics that together support better coordinated and effective population management.

Under this new model, Anthem will compensate SVHP for important clinical care coordination work and the adoption and expansion of patient-centered care principles within SVHP practices. In addition, SVHP will be eligible to share in savings that are made possible by this patient-centered care delivery model that helps in reducing avoidable hospital readmissions and emergency room visits. This value-based payment model has been proven to promote clinical quality and manage health care spending in numerous studies.

"Unlike traditional physician-hospital relationships, which are often inefficient and can result in fragmented patient care, SVHP plans to align physician and hospital efforts through active coordination of care and data sharing," said Thomas A. Raskauskas, MD, President and CEO St. Vincent's Health Partners. "Patients will benefit greatly from SVHP, receiving better healthcare across the entire continuum of care."

"St. Vincent's Medical Center has participated in Anthem's Quality-In-Sights^® Hospital Incentive Program (Q-HIP^®) for many years and has consistently scored at the highest levels of performance. Anthem is pleased to embark on this next chapter of quality improvement with the hospital and its physician organization," said Peter Bowers, MD, Chief Medical Officer, Anthem Blue Cross and Blue Shield. "As Connecticut's largest commercial health insurer, we believe we have a unique opportunity to use our size, scope, and experience to bring about substantive improvements in health care delivery that will benefit people in Connecticut," added Dr. Bowers.