Anthem becomes first commercial health insurer to offer performance bonuses to doctors based on quality benchmarks set up by the Quality Health First® program
(INDIANAPOLIS– September 10, 2008) – To support innovative approaches to transforming healthcare delivery, Anthem Blue Cross and Blue Shield in Indiana has made a commitment to participate in the Indiana Health Information Exchange’s Quality Health First (QHF) program. This program will help physicians manage patients with chronic diseases, support preventive care efforts, and serve as Anthem’s quality reporting tool for primary care physicians in the nine county Indianapolis area.
The QHF program was designed by the Indiana Health Information Exchange and the Employers’ Forum of Indiana. It builds upon a system that securely aggregates and accurately delivers patient information such as lab results, reports, medication histories, treatment histories and more in a standardized, electronic format, across all providers. This system, called the Indiana Network for Patient Care (INPC), is operated by the Regenstrief Institute, and is widely considered the nation’s most advanced and secure community health record system.
“The Indiana Health Information Exchange is widely recognized as the trendsetter for medical information exchange,” said David Lee, M.D., Vice President of Health Care Management for Anthem Blue Cross and Blue Shield in Indiana. “As a leading health benefits company in Indiana, we are pleased to support the Quality Health First program because timely, accurate information is essential to improving the quality, and ultimately, the cost of healthcare. We encourage other stakeholders to lend their support. “
Anthem-network primary care physicians in central Indiana who perform in the top 20 percent according to the quality metrics will receive a 10 percent increase in reimbursement from Anthem for the most commonly billed medical services. For a
typical central Indiana primary care physician, this could translate to $10,000 to $20,000 a year in additional reimbursement from Anthem.
Currently 700 physicians have signed up to participate in the service. Physicians will receive monthly reports to proactively monitor those patients who are due or overdue for certain tests and screenings. For example, they can view which patients are getting tests completed, those results, and which patients have yet to come in for testing.
Other components of the QHF program include:
- It uses clinical data from the INPC and claims data from participating health insurers, including Anthem Blue Cross and Blue Shield.
- It is designed to work with existing paper-based or electronic-based medical record physician systems,
- Participation by physicians is free,
- The reporting is across all participating health insurers,
- The incentive is based upon the physician group score across all participating health insurers,
- It was designed in conjunction with physicians, along with other healthcare stakeholders; and
- It focuses on measures that the Indianapolis-area medical community has identified as priorities (asthma care, breast cancer screening, cholesterol screening and management and diabetes screening and management).
According to the Milken Institute, the cost of treatment and lost productivity caused by chronic illnesses in the U.S. is more than $1.3 trillion annually. If left unchanged, costs could reach $6 trillion by 2050.“The Quality Health First program was designed to directly address this problem by bringing together healthcare providers and healthcare plans to cooperatively improve patient care,” said Dr. J. Marc Overhage, President and CEO of the Indiana Health Information Exchange. Overhage also serves as Director of Medical Informatics at the Regenstrief Institute, Inc. and is Regenstrief Professor of Medical Informatics at the Indiana University School of Medicine.
He continued, “The Indianapolis-area healthcare community – physicians, physician groups, health plans, hospitals, employers and other key stakeholders – have come together through this program for one common purpose: to support patient care. Ultimately, it is our aim that patients will have fewer complications and physicians will have more satisfaction with healthier patients.”
About Anthem Blue Cross Blue Shield in Indiana:
Anthem Blue Cross and Blue Shield is the trade name of Anthem Insurance Companies, Inc., an independent licensee of the Blue Cross and Blue Shield Association. ® ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross and Blue
Shield names and symbols are registered marks of the Blue Cross Blue Shield Association. Additional information about Anthem Blue Cross and Blue Shield in Indiana is available at www.anthem.com.
About the Indiana Health Information Exchange:
Indiana Health Information Exchange, Inc. (IHIE) is a non-profit corporation formed by the Regenstrief Institute, private hospitals, local and state health departments, BioCrossroads and other prominent organizations in Indiana. It is dedicated to supporting communities by providing services that enable the right medical information to get to the right provider at the right time. To learn more, visit www.ihie.com.