Anthem Touts Results of Effort to Cut Health Costs

Health insurer’s program provides doctors with additional payments if they lower cost of patients’ care

Anthem Inc. said a major effort to overhaul how it pays primary-care doctors appears to be lowering overall health-care costs, as patients spend less time in the hospital.

The second-biggest U.S. health insurer unveiled a high-profile program in 2012 that provided doctors with additional payments and an opportunity to earn more if they lowered the cost of patients’ care and met quality requirements.

The initiative includes around 37,000 primary-care physicians and is expected to involve 4.4 million Anthem members by the end of this year.

Now, Anthem is releasing results from the first 12 months of the program. Overall, the insurer said, it believes the initiative reduced costs by around 3.3%, including drops in hospital admissions, outpatient surgery and emergency-room spending.

Meredith Rosenthal, a professor at the Harvard School of Public Health who wasn’t involved in Anthem’s review, said that if the early results “hold up, it would be quite a success.” The study appeared to show savings without a diminution of quality of care, she said, but more time and analysis will be needed to fully gauge the effort.

The insurer said the costs for patients in the program dropped by 3.3% compared with results for nonparticipating patients. The analysis looked at the change between the 12 months before the program started and the first year of enrollment.

That translated into savings of $9.51 per member per month, or net savings of $6.62 after the costs of the program were factored in. Overall, Anthem pegged the net savings at between $81 million and $102 million for the patients and time period tracked in the study.

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