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Enhanced Personal Health Care Program – Medical Panels

PW_E185958
The Program introduces the concept of the Medical Panel to encourage broad-based practice participation across markets while helping to ensure that patient access needs are met and physician performance assessment is statistically valid. The Medical Panel structure will support collaborative learning and community accountability for quality and affordability. As outlined in the Program Description Medical Panels will also serve as the basis for establishing Savings Pools, which contribute to the amount a practice receives under the Incentive Program.  
Formation of Medical Panels
Medical Panels can be composed of individual physician practices or a group of practices. During a period of time prior to the start date of the Measurement Period, you may have the opportunity to submit your preference for your Medical Panel to us. If such opportunity is available, this page will include a form for submission of Medical Panel preferences, as well as a list of practices that have been selected for participation in the Program. Prior to the Measurement Period start date, Anthem will assign Medical Panels for participating practices, and this information will be available on the secure provider portal. You will have an opportunity to review your Medical Panel assignment at that time. If you are satisfied with your assigned Medical Panel, or you do not submit your preference to us within the timeline indicated on the Anthem provider portal, you will remain in your assigned Medical Panel for the duration of the Measurement Period. Anthem will make reasonable efforts to consider all preferences submitted in a timely manner; however, we cannot guarantee that all preferences will be accommodated. Anthem reserves the right to make all final determinations on Medical Panel formation.  
CPC Specific Terms: The opportunity to submit Medical Panel preferences may not be available under the CPC Initiative because all practices participating in the CPC Initiative may need to be combined to form a Medical Panel. If this is the case, the list of physician practices identified above may not be available via the Anthem provider portal. This will be determined prior to the start date of the Measurement Period.  
 
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Anthem Blue Cross and Blue Shield is the trade name of: In Colorado Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc. In Connecticut: Anthem Health Plans, Inc. In Indiana: Anthem Insurance Companies, Inc. In Kentucky: Anthem Health Plans of Kentucky, Inc. In Maine: Anthem Health Plans of Maine, Inc. In Missouri (excluding 30 counties in the Kansas City area): RightCHOICE® Managed Care, Inc. (RIT), Healthy Alliance® Life Insurance Company (HALIC), and HMO Missouri, Inc. RIT and certain affiliates administer non-HMO benefits underwritten by HALIC and HMO benefits underwritten by HMO Missouri, Inc. RIT and certain affiliates only provide administrative services for self-funded plans and do not underwrite benefits. In Nevada: Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc., dba HMO Nevada. In New Hampshire: Anthem Health Plans of New Hampshire, Inc. In Ohio: Community Insurance Com pany. In Virginia: Anthem Health Plans of Virginia, Inc. trades as Anthem Blue Cross and Blue Shield in Virginia, and its service area is all of Virginia except for the City of Fairfax, the Town of Vienna, and the area east of State Route 123. In Wisconsin: 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. Use of the Anthem Web sites constitutes your agreement with our Terms of Use