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
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