TriHealth, Anthem Demonstrate Power of Value-Based Healthcare to Improve Preventive Care, Lower Cost

November 15, 2018

November 15, 2018

TriHealth and Anthem Blue Cross and Blue Shield in Ohio today announced that, as a result of a joint value-based care agreement launched in 2014, southwest Ohio consumers experienced increased preventive healthcare and lower costs.

Anthem consumers receiving care through TriHealth-affiliated primary care physicians, specialists and facilities experienced increased preventive care, including children’s annual checkups, diabetes testing and management, and vaccination rates.

“At Anthem, we strive to make health care simpler, more affordable and more accessible for consumers said Steve Martenet, president of Anthem Blue Cross and Blue Shield in Ohio. “Our collaborative work with TriHealth is proof that quality and lower cost go hand-in-hand. This model is the key to preventing health concerns from becoming health emergencies, and we will continue to lead the industry in developing these kinds of partnerships with doctors and hospitals.”

The Anthem/TriHealth partnership is designed to support primary care providers through payment incentives in coordinating, planning and managing care for their consumers. Highlights of 2017 full-year results from the Anthem/TriHealth value-based healthcare partnership include:

  • 93 percent well-child immunization rate
  • 79 percent breast cancer screening rate
  • 78 percent medication adherence rate
  • Combined diabetic complication screening rate of 79 percent
  • Combined annual well-child primary care visit rate of 74 percent, with three target age range metrics breaking down as follows:
    • For kids 15 months old or younger, 89 percent
    • For kids three to six years old, 90 percent
    • For kids 12 to 21 years old, traditionally a very difficult age to achieve high well-child visit rates, 67 percent.

Each of the above metrics places TriHealth at or above the 80thpercentile among all Ohio health systems, according to Anthem data, making TriHealth the top performing health system in Anthem’s value-based health care program. These and other preventive care and care coordination efforts resulted in significantly lower cost of care for the Anthem consumers cared for by TriHealth physicians. Through the Anthem/TriHealth partnership, a portion of the cost savings will be returned to TriHealth, allowing for further investment in primary care, preventive health and chronic disease management programs. The remaining cost savings will be used to address health insurance premiums for Anthem consumers and employers.

“TriHealth and its nearly 14,000 physicians, nurses and other team members are proud to be recognized as Anthem’s top performing accountable care organization in the state of Ohio and among the best in the entire country,” said Mark C. Clement, president and CEO of TriHealth. “At TriHealth, we are committed to getting healthcare right for the community by focusing on the triple aim of better health, better care and better value. This recognition by Anthem is evidence of the progress we are making.”

Last Updated: November 15, 2018