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Anthem pulling out of Quality Health First

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Anthem Blue Cross and Blue Shield of Indiana will end its involvement in the Quality Health First program on May 31, sending the initiative’s creators scrambling for a new path forward.

Since 2009, Indianapolis-based Anthem has doled out $14.5 million in bonuses to physicians based on their scores in quality reports generated by Quality Health First.

Anthem will continue to pay bonuses through the end of 2013, but it will stop funding the operations of Quality Health First on May 31. That undisclosed amount of funding goes primarily to the Indiana Health Information Exchange, which provides the information technology services that generate the Quality Health First reports.

So the creators of the Quality Health First program now are looking to see if large employers and large physician groups might be willing to fund its work in the future.

“We’re going to meet with employers to find out if there’s enough value in employer reporting and public reporting to sustain the project—and then meet with the major medical groups,” said Dave Kelleher, executive director of the Employers Forum of Indiana, which created Quality Health First in 2006.

There are currently 2,200 physicians participating in Quality Health First.

Kelleher said Quality Health First was destined to become a public reporting service anyway, because most health insurers other than Anthem did not have enough of a market presence in Indiana to justify supporting the plan. Quality Health First also had received some funding from Minnesota-based UnitedHealthcare and Anderson-based Unified Group Services.

But Anthem, which is a subsidiary of Indianapolis-based WellPoint Inc., ultimately decided to embrace a new plan WellPoint is rolling out in the 14 states where it operates.

That plan, called Patient Centered Primary Care, will pay family doctors and internists about 10 percent more for their services, in a bid to manage patients’ chronic diseases more effectively, rather than pay for expensive specialist care once they get out of hand.

WellPoint announced the program nearly a year ago, and started operating it in six states on Jan. 1. Anthem plans to roll out the so-called PC2 program in Indiana on Jan. 1, 2014.

“Anthem paid $14.5 million in bonuses to physicians participating in Quality Health First during the last four years because we strongly believe that improved patient outcomes and high-quality medical care should be rewarded," Anthem spokesman Tony Felts wrote in an e-mail. "This philosophy will continue under a new program that Anthem is introducing to the market this year."

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  1. Good ole' Obamacare. Thanks liberals and those who didn't bother to vote.

  2. Yes. Blame those who were too lazy to go vote Obama out and those who voted him in again. That's my take on it. I know folks won't get it on the left. OK. Start berating me now!

  3. Serioulsy, people are AGINST this project? Most communities would be salivating over a project like this. You'd rather have an empty eye-sore gas station and shacks posing as apartments? This project is exactly what BR needs. BUILD IT MR MAYOR. And yes, I am a BR resident, and have been for 20 years.

  4. As a St. Vincent employee of over 20 years, I am saddened and disheartened by this announcement. Unfortunately, as the healthcare "industry" continues on this political and corporate path, all that St. Vincent Hospital has stood for spiritually for its employees and this community is being sucked dry. I know it truly has no choice. It is not just Obamacare or just competition or just any single thing. This trend started long before I was even born when the government became involved in healthcare and it became an "industry." I grieve for those who will lose their jobs, one of whom may be me, but I also grieve for this hospital which I have served for over 20 years. May God give us and it the grace to withstand the future of healthcare.

  5. Why do people constantly harp on this issue and act ignorant about what a city population measures? A city's population is the city's population. There is no argument or debate about it. If you want to measure the density of a city--measure it. If you want to measure the size of a metropolitan area, then measure the metropolitan population. City boundaries cover different sized areas--and they always have (though the disparity has probably increased since about 1900 or so when more cities began annexing their surrounding communities). For example, San Francisco only covers 49 square miles while Houston cover nearly 600 square miles. No one argues about the population rankings of either city even though they clearly cover extremely different sized areas. Indianapolis is the 13 largest city by population in the U.S. That is a fact. While the population of a metropolitan area may give you a better sense of how large a community is, as noted, even metro areas can vary widely in the size of geographic area they cover--so that is not a perfect comparison either.

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