WOODLAND HILLS, Calif.--(BUSINESS WIRE)--Anthem Blue Cross today announced that members of the Vivity by Anthem Blue Cross health plan can now request that their assigned primary care physician refer them to a specialist at another group within the Vivity network. Vivity is the only HMO in California to offer this to their members.
Vivity is a first-in-the-nation joint venture between a health plan and seven like-minded hospital systems that have aligned to enhance the health of all Vivity by Anthem Blue Cross members and utilizes a unique provider reimbursement structure that includes shared savings from community risk pools.
The seven hospital systems – all with hospitals ranked in the top 30 in Los Angeles County by U.S. News & World Report – are Cedars-Sinai, Good Samaritan Hospital, Huntington Memorial Hospital, MemorialCare Health System, PIH Health, Torrance Memorial Medical Center and UCLA Health.
“When we launched Vivity on Jan. 1, 2015, we promised that one of the unique features of this partnership would be the ability for members to be referred from one medical group to specialists at another medical group,” said Beth Ginzinger, vice president for provider joint ventures. “We are now delivering on that promise – and we are the only ones in the marketplace providing this in a HMO setting.”
For example, a member assigned to Cedars-Sinai’s medical group could be referred to a specialist at Torrance Memorial, or a member assigned to PIH Health’s medical group could be referred to a cardiologist at Huntington Memorial. The referral is subject to the particular specialist having agreed to see members from other medical groups and the member’s primary care physician’s determination that the specialist visit is medically necessary.
The feature became available to Vivity by Anthem Blue Cross members after a change to the health benefit plan reviewed by the Department of Managed Health Care.
Vivity also announced that it exceeded its sales goal for 2015, and set an ambitious target of 35,000 members for 2016.
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