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TMCNet:  Esse Health and Anthem Blue Cross and Blue Shield Join in Agreement to Improve Quality and Decrease the Cost of Care

[February 17, 2014]

Esse Health and Anthem Blue Cross and Blue Shield Join in Agreement to Improve Quality and Decrease the Cost of Care

ST. LOUIS --(Business Wire)--

Anthem Blue Cross and Blue Shield in Missouri announced today that Esse Health is entering into a patient-centered care agreement with Anthem that will create an accountable care model to help ensure Anthem members access to quality health care focused on improved outcomes and lower costs.

Anthem continues to expand its work to support patient-centered care, a model that will help drive improvements in both the quality of care and cost of care. Under this new model, Anthem will support the important clinical care coordination work Esse Health does between traditional office visits, as well as support the adoption and expansion of patient-centered care principles within Esse Health. Esse Health will be eligible to share in savings that are made possible from improved care coordination, such as reduced duplication of services and more timely intervention of care.

Under the patient-centered care model, Esse Health will coordinate care for its patients, work to improve their overall health, and work to reduce avoidable hospital readmissions and emergency room visits by helping patients manage chronic disease and prevent illness.

"Esse Health physicians have long supported the concept of the patient centered medical home," said Mike Castellano, CEO of Esse Health. "We are pleased to be working with Anthem toward achieving the same goal - promoting high quality, cost-effective care for those we serve."

"We value the importance of primary care physicians in the care delivery model. For that reason, we designed our program to empower and incentivize primary care physicians to manage the overall health of their patients," said Kate Lichtenberg, D.O., physician director of the Enhanced Personal Health Care initiative at Anthem Blue Cross and Blue Shield inMissouri. "We cannot have a sustainable health care system with traditional fee-for-service payment. This innovative model will advance payment reform in Missouri, while helping improve the health of our members, and be a model for all providers and insurers in the state."


Both organizations noted that this effort is yet another element of a strong collaboration between the entities.

About Anthem Blue Cross and Blue Shield in Missouri

In Missouri (excluding 30 counties in the Kansas City area) Anthem Blue Cross and Blue Shield is the trade name for RightCHOICE® Managed Care, Inc. (RIT), Healthy Alliance® Life Insurance Company (HALIC), and HMO Missouri, Inc. RIT and certain affiliates administer non-HMO benefits underwritten by HALIC and HMO benefits underwritten by HMO Missouri, Inc. RIT and certain affiliates only provide administrative services for self-funded plans and do not underwrite benefits. Independent licensees 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 Missouri 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 Esse Health

Esse Health is a St. Louis-based, independent physician group that strives to improve the overall well-being of its patients through patient education, lifestyle modification and prevention. With 36 locations throughout the St. Louis and Metro East area, Esse Health's services include asthma, allergy and immunology, family medicine, internal medicine, nutrition, pediatrics, radiology, urology, cardiology, rheumatology and gastroenterology. Esse Health is recognized as a leader in using technology in health care and physician accountability for both quality and cost of care. For more information on Esse Health, visit www.essehealth.com.


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