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Anthem Blue Cross and Blue Shield and St. Vincent's Health Partners Collaborate to Develop Innovative Provider Reimbursement Model
[June 14, 2013]

Anthem Blue Cross and Blue Shield and St. Vincent's Health Partners Collaborate to Develop Innovative Provider Reimbursement Model


WALLINGFORD, Conn. & BRIDGEPORT, Conn. --(Business Wire)--

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.

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. Anhem 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.



About Anthem Blue Cross and Blue Shield in Connecticut

Anthem Blue Cross and Blue Shield is the trade name of Anthem Health Plans, Inc., an independent licensee of the Blue Cross 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 and Blue Shield Association. Additional information about Anthem Blue Cross and Blue Shield in Connecticut is available at www.anthem.com. Also, follow us on Twitter (News - Alert) at www.twitter.com/healthjoinin, on Facebook (News - Alert) at www.facebook.com/HealthJoinIn, or visit our YouTube (News - Alert) channel at www.youtube.com/healthjoinin.


About St. Vincent's Health Partners

In response to the rapidly-changing healthcare environment, in June 2012 regional physicians and the 473-bed St. Vincent's Medical Center, (www.stvincents.org) developed a new physician hospital organization (PHO), St. Vincent's Health Partners, Inc. (SVHP). Serving southwestern Connecticut, SVHP, a PHO comprised of more than 300 healthcare providers and St. Vincent's Medical Center, provides a strategy to improve patient care in this new environment.

The St Vincent's Health Partners PHO aligns physician and hospital efforts through active coordination of care and data sharing. As a result of this collaboration, patients receive better healthcare across the entire continuum of care. Through its partnership and shared information technology, SVHP allows participating primary care and specialist physicians to perform well under new healthcare reimbursement models that reward clinical integration and improved quality of care. For more information, visit us at www.stvincentshealthpartners.org.


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