Here are five key points on the program’s first year results:
1. The program yielded $9.51 in gross savings per attributed member per month for those members who saw EPHC providers.
2. The program lowered outpatient surgery costs by 5.1 percent for PaMPM.
3. The value-based program experienced a 7.4 percent drop in acute admissions for high-risk patients with chronic conditions. Comparatively, the program saw a 22.9 percent increase per 1,000 primary care provider visits for high-risk patients.
4. Anthem’s program lowered emergency room costs by 3.5 percent and ER utilization by 1.6 percent.
5. Compared to non-participating EPHC providers, EPHC providers have the following percent increases in quality metrics:
● Pediatric prevention: 9.6 percent
● Annual monitoring of persistent medications: 4.8 percent
● Diabetes care: 4.3 percent
● Adult prevention: 4.3 percent
● Acute and chronic case measures: 3.9 percent
More articles on coding & billing:
Aetna may completely withdraw from exchanges due to ACA uncertainty: 5 things to know
Medicaid spending totals $575.9B in 2016 — 9 key points
84% of US voters say officials should not repeal ACA without implementing alternative: 4 key points
At the Becker’s 32nd Annual Meeting: The Business and Operations of ASCs, taking place October 29-31 in Chicago, ASC leaders, surgeons and healthcare executives will explore strategies to drive growth, enhance operational performance, navigate reimbursement challenges and prepare for the future of ambulatory surgery. Apply for complimentary registration now.
