There are medical advancements every day and the health care system has undergone significant change over the past few years. Anthem is at the forefront of changes to the health care system. By reinventing how health care is administered with innovative changes in treatment plans, research advancements and the exchange of information, our plans are giving providers the tools they need to give consumers the best care possible.
Cancer Care Quality Program
Thanks to medical innovation, there are more cancer treatment options than ever before. Survival rates for many types of cancer have reached all-time highs. But research shows that there’s a lot of variation in treatment practice patterns and quality of care; and costs have never been higher.
To tackle these quality and cost issues for chemotherapy treatment of cancer, Anthem worked with its subsidiary AIM Specialty Health to develop the Cancer Care Quality Program.
The Cancer Care Quality Program identifies certain cancer treatment pathways based upon current medical evidence, peer-reviewed published literature, consensus guidelines and Anthem’s clinical policies in order to support oncologists in identifying cancer treatment therapies that are highly effective and provide greater value. The program also provides oncologists who are in-network for a member’s health benefit plan with enhanced reimbursement to offset the lower fees they receive when prescribing less expensive drugs.
Anthem is trying to shift the paradigm on cancer quality and how our plans pay for cancer care. By reimbursing for treatment planning and care coordination, it helps to weaken the link between drug margin and practice revenue. Our hope is that this program will result in improved quality and less variation regardless of the drug reimbursement.
Anthem, Inc. and its subsidiaries are also working with leaders in the pharmaceutical industry to transform disconnected data sets into real world results. This is the kind of research that will advance traditional thinking and translate into better treatment outcomes for consumers.
Just this year, a five-year research collaboration between Boehringer Ingelheim, Anthem and Anthem subsidiary HealthCore seeks to generate real-world evidence and develop health economics and outcomes data to inform the development and evaluation of new medicines, guidelines and interventions. Of initial interest are aims to identify gaps in non-valvular atrial fibrillation research, development and treatment.
Similarly, Anthem and HealthCore are working with Eli Lilly and Company to jointly develop and conduct research projects in health outcomes and real-world evidence in areas of mutual interest.
Together, the companies plan to explore issues related to appropriate use of existing and new therapies and interventions, and the impact these have on clinical and economic outcomes that matter the most to patients. It’s collaborations like these with trusted experts in their fields that will result in true advancements in care and therapies—closing gaps by creating new strategies.
Anthem knows that gaps also exist for consumers when they receive health care from various doctors at different health care systems—doctors aren’t getting a true, holistic view of the care that consumers have received if their treatment information isn’t shared. Often, when consumers are being treated by more than one doctor, those professionals cannot see the treatments and tests the others are prescribing, particularly if they work in different health care systems. Fortunately, this is changing.
In California, Anthem Blue Cross is a founding member of Cal INDEX, a new statewide health information exchange. Through Cal INDEX, participating doctors, nurses and hospitals across systems and offices can access patients’ health records so they can provide better, more cost-effective care. When a consumer receives services from a participating doctor or hospital, their health record is updated so other Cal INDEX participants can see a more complete view of their patient’s health history. This not only helps avoid duplicative procedures and potential drug interactions, but also makes health information available in emergency situations so care can be delivered more effectively. Anthem is facilitating the creation of complete health records, fostering research collaborations and utilizing evidence-based cancer treatment pathways. Imagine a more educated physician armed with the best medical data to treat the patient—this is how Anthem is reinventing health care.