New Anthem Blue Cross plan takes on Kaiser – LA Times

Overall, Vivity will comprise 6,000 doctors and 14 hospitals across the seven health systems.But Anthem wants to work with these medical centers to keep as many patients as possible from ever setting foot inside the hospital.

“Under the current model, hospitals want to keep occupancy rates up,” said Pam Kehaly, Anthem’s west region president and a key architect of this deal. “This is in complete opposition to that. For this joint venture to succeed, we have to keep occupancy rates down.”

Susan Ridgely, a senior policy analyst at the Santa Monica think tank Rand Corp., said these hospitals are probably betting that they can attract enough new patients and referrals through Vivity to offset the gradual decline in inpatient admissions.via New Anthem Blue Cross plan takes on Kaiser – LA Times.

Anthem Blue Cross is adopting an accountable care organization (ACO)-like strategy in Southern California where it and hospitals jointly benefit from reducing costly patient admissions. It reverses the current economic model in which health plan issuers and hospitals have conflicting interests to one based on the principle that enhanced access to lower cost care is better for both payers and providers than costlier hospital admissions. An innovative development worth watching.


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