WAUKESHA, Wis.--(BUSINESS WIRE)--ProHealth Care will join Anthem Blue Cross and Blue Shield’s Blue Priority network on Dec. 1, 2014, making all of ProHealth’s professionals, services and facilities available to network members.
Blue Priority is Anthem Blue Cross and Blue Shield’s high-value network in Wisconsin. It’s the network used by all Anthem Blue Cross and Blue Shield Individual health plans sold through the state’s federally-facilitated health insurance exchange, and it is available to employers through fully-insured and self-funded health benefits arrangements.
“We are pleased to join Blue Priority,” said Susan Edwards, chief executive officer of ProHealth Care. “Collaboration with the progressive, value-focused health care providers in the Anthem network will allow us to further enhance the quality of care we provide and the health of the communities we serve.”
The Blue Priority network offers access to quality care at a market-leading value in 45 Wisconsin counties, where more than three-quarters of the state’s residents reside. The network includes all seven members of the newly established statewide provider partnership as well as the Children’s Hospital System in Milwaukee, Meriter Health Services in Madison and select clinics and physicians to ensure access across the entire geography covered by the network.
“We launched Blue Priority two years ago with the expectation that it would spark innovation and competition around the critical issues of cost, quality and efficiency,” said Larry Schreiber, president of Anthem Blue Cross and Blue Shield in Wisconsin. “It has done all that and more, and we’re excited to continue adding to the network health systems that share our passion for high value, patient-centered care. ProHealth Care is a leader in those efforts and we look forward to having them join the network in December.”
Blue Priority works to improve health by combining the clinical expertise of Anthem Blue Cross and Blue Shield and its participating health systems. In a deeply collaborative effort, the organizations work together to unlock the power of clinical data and claims records to produce personalized, patient-centered care that improves the overall health of the Blue Priority patient population.
Efficiencies and savings are achieved through a focus on:
- Helping those in good health stay healthy;
- Providing care and disease management services that help individuals manage their health conditions more effectively;
- Driving improvements in the overall health of all Blue Priority members through preventive care and appropriate interventions; and
- Creating financial incentives between the provider and insurer to improve overall efficiency and quality.
According to Health Affairs, a third or more of health care spending in the United States – or $690 billion a year – may be wasteful. Factors such as a lack of care coordination, overtreatment, and administrative complexity can result in unnecessary costs.*
In Wisconsin, the Anthem Blue Cross and Blue Shield Blue Priority network is addressing these issues head on. It is breaking down longstanding divides between its participating provider systems and the health insurer in order to improve the quality of health care delivered to patients.
Health care organizations in the Anthem Blue Cross and Blue Shield Blue Priority network:
- Use electronic medical records to actively manage patient cases;
- Exchange data electronically between the health care organization and Anthem Blue Cross and Blue Shield;
- Reward doctors for value and outcomes, versus the volume of services provided;
- Have leadership support within the health system necessary to drive needed change and identify efficiencies;
- Use data-driven metrics to allow for the identification of best practices, comparative effectiveness measurement and peer evaluation; and
- Engage in proactive quality initiatives within their systems.
Businesses interested in learning more about Blue Priority and getting a rate quote should contact their insurance broker. Individuals can learn more about Blue Priority from their insurance broker, Anthem.com and HealthCare.gov.
*Source: “Health Policy Brief: Reducing Waste in Health Care,” Health Affairs, December 13, 2012.
About Anthem Blue Cross and Blue Shield in Wisconsin
Anthem Blue Cross and Blue Shield is the trade name of Blue Cross Blue Shield of Wisconsin (BCBSWi), which underwrites or administers the PPO and indemnity policies; Compcare Health Services Insurance Corporation (Compcare), which underwrites or administers the HMO policies; and Compcare and BCBSWi collectively, which underwrite or administer the POS policies. Independent licensees of the Blue Cross and Blue Shield Association. ® ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. Additional information about Anthem Blue Cross and Blue Shield in Wisconsin is available at www.anthem.com. Also, follow us on Twitter at www.twitter.com/healthjoinin, on Facebook at www.facebook.com/HealthJoinIn, or visit our YouTube channel at www.youtube.com/healthjoinin.
About ProHealth Care
For a century, ProHealth Care has been the health care leader in Waukesha County and surrounding areas, providing outstanding care across a full spectrum of services. The people of ProHealth Care strive to continuously improve the health and well-being of the community by combining skill, compassion and innovation. The ProHealth family includes Waukesha Memorial Hospital, Oconomowoc Memorial Hospital, the Rehabilitation Hospital of Wisconsin, ProHealth Care Medical Associates clinics, Moreland Surgery Center, AngelsGrace Hospice, ProHealth Home Care, West Wood Health & Fitness Center and Regency Senior Communities. Learn more at ProHealthCare.org.