In an effort to help physicians manage patients with chronic diseases, Anthem Blue Cross and Blue Shield in Indiana will participate in the Indiana Health Information Exchange's Quality Health First (QHF) program.
The program will serve as Anthem's quality reporting tool for primary care physicians in the nine-county Indianapolis area.
Designed by the Indiana Health Information Exchange and the Employers' Forum of Indiana, the QHF program aggregates and delivers patient information such as lab results, reports, medication histories and treatment histories in a standardized electronic format. This system, called the Indiana Network for Patient Care (INPC), is operated by the Indianapolis-based Regenstrief Institute, an informatics and healthcare research organization.
"The Indiana Health Information Exchange is widely recognized as the trendsetter for medical information exchange," said David Lee, MD, vice president of healthcare management for Anthem Blue Cross and Blue Shield in Indiana. "As a leading health benefits company in Indiana, we are pleased to support the Quality Health First program because timely, accurate information is essential to improving the quality and, ultimately, the cost of healthcare. We encourage other stakeholders to lend their support."
Anthem-network primary care physicians in central Indiana who perform in the top 20 percent according to quality metrics will receive a 10 percent increase in reimbursement from Anthem for the most commonly billed medical services. For a typical central Indiana primary care physician, this could translate to $10,000 to $20,000 a year in additional reimbursement from Anthem.
Currently 700 physicians have signed up to participate in the service. Physicians will receive monthly reports to proactively monitor those patients who are due or overdue for certain tests and screenings. For example, they can view which patients are getting tests completed, those results, and which patients have yet to come in for testing.
"The Indianapolis-area healthcare community - physicians, physician groups, health plans, hospitals, employers and other key stakeholders - has come together through this program for one common purpose: to support patient care. Ultimately, it is our aim that patients will have fewer complications and physicians will have more satisfaction with healthier patients," said J. Marc Overhage, president and CEO of the Indiana Health Information Exchange.
Some components of the QHF program include:
(bullet) the use of clinical data from the INPC and claims data from participating health insurers;
(bullet) an incentive based on the physician group score across all participating health insurers; and
(bullet) a focus on measures that the Indianapolis-area medical community has identified as priorities (asthma care, breast cancer screening, cholesterol screening and management and diabetes screening and management).