Innovations From Employers Driving System Reform Paige Rothermel, Vice President and General Manager Anthem CA Large Group April 6, 2016.

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Presentation transcript:

Innovations From Employers Driving System Reform Paige Rothermel, Vice President and General Manager Anthem CA Large Group April 6, 2016

Why Innovate? 37% 62% Engaged At-Risk <1% (.579%) UnEngaged At-Risk 62% Rest of Population Low engagement, high costs, minimal control over costs Un-engaged At-Risk = Spend for Members with $8k+ Claims

Proactive, Simple & Connected Data ACO Optimization Clinical Insights Telemedicine Onsite Clinics Population Health Wellness Incentives Analytics Providers under value based contracts HEDIS Measures 37% 62%

A Holistic Approach Yields Better Results OUTREACH Mobile • Email ENGAGEMENT Population Health & Wellness Consumerism Communications Aggregation Tablet Web Push notifications RISK IDENTIFICATION Assessment Wearables Adherence 37% 62% PROVIDER COLLABORATION Steerage: High value providers Onsite clinic Provider under a value based contract Simple – Guided Consumer Experience MEASUREMENT Real time employer analytics

Care Gap Improvements It’s Working! 37% 62% 41% A1c testing 17% compliance in 2014, a 103% improvement 24% Pap smear screening 5.6% compliance in 2014, a 309% improvement 14% ACE or ARB medication refill 8% compliance in 2014, a 52% improvement 37% 62% It’s Working! 87% Disease Management Engagement + 200% Year over Year Improved Engagement 26% Disease Management Completion + 700% Year over year Improved Completion

Commitment to Excellence Introducing Vivity: Redefining the relationship between member, hospital, doctor & health plan Collaboration 37% 62% Quality Consumerism

Vivity Mobile Health Consumer Customized digital health companion connecting Health Plan, Provider and Patient information Connectivity to care team, patient portal and website information Urgent Care Centers with dial and drive direction enabled ID card and plan benefit summary Linked to LiveHealth Online and Anthem.com Customized ‘take action’ healthy tips and gaps in care messaging Earn participation incentives