Hospital, insurer team up


Staff report



DAYTON — Premier Health and Anthem Blue Cross and Blue Shield in Ohio have teamed to offer value-based health care in the Miami Valley.

Value-based health care, a fast-growing national model for care delivery and payment, centers the health care delivery system on primary care physician practices. Anthem’s model arms health care providers with enhanced data and analytics to more effectively coordinate patient care, focus on preventive health, manage chronic disease and lower overall costs.

The agreement aligns with Premier’s population health model and is built on Anthem’s Enhanced Personal Health Care model that provides for value-based compensation based on quality measures and shared savings through better health. The new arrangement includes Anthem employer-based, individual and Medicare Advantage members. Anthem is Ohio’s largest commercial health insurer with nearly four 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/patient health rather than economics alone, we are confident that this will benefit the entire community.”

Premier Health is the largest health system in Southwest Ohio and features four member hospitals, along with affiliate partners, such as a large primary care and specialty physician network, community health, home health, and behavioral health partners. Patients and their families are served by over 14,000 employees and nearly 2,600 physicians in more than 70 specialties. Premier offers over 100 access points that provide services across the region.

Anthem’s Enhanced Personal Health Care model incentivizes Premier Health doctors for lowering 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,” explained Anthem Blue Cross and Blue Shield in Ohio President Steve Martenet. “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.”

Staff report