Addressing Healthcare Affordability in New York

Delivering Better Health Through Affordable Care

At Anthem Blue Cross and Blue Shield, we’re committed to advancing access to affordable care for our members in New York. Affordability is central to improving health outcomes and creating a better member experience where people can get the care they need when they need it.

What’s Driving Costs

 

There are many factors driving up costs, which have a ripple effect across families, businesses and communities. Some of the biggest factors include: 

 

• Aging population: More older adults needing more complex and costly care. 
• Chronic conditions: Obesity, diabetes, and heart disease are becoming more common and therefore more expensive. 
• Drug costs: Prices of existing drugs and specialty drugs increase at rates faster than inflation, and new drugs start at record-high prices. 
• Provider consolidation: When healthcare providers merge, it often leads to higher prices and fewer choices. 
• Fraud, waste, and abuse: The complexity of our system makes it easier to abuse. 
• Legislation: Recent federal and state changes continue to mean added costs in the system, year after year. 

 

Given the complex nature of healthcare costs, we’re focused on solutions that go beyond traditional cost control measures. 

What We’re Doing to Improve Healthcare Affordability

 

 

Here are some of the things that Anthem is doing today to make healthcare more affordable in New York:

 

  • Helping seniors manage complex care so they avoid unnecessary hospital stays. 
  • Better chronic condition management to help members keep their disease and costs in check.
  • Negotiating lower prices for prescription drugs, especially expensive specialty drugs.
  • Implementing value-based care models with physicians so they are paid for the quality of care they deliver, not the number of services they provide. These agreements promote stronger health outcomes for members.
  • Giving members (in certain plans) rewards through programs like SmartShopper when they use our tools to compare prices.
  • Using AI to detect potentially fraudulent activity and improper claims. 
  • Advocating for policies at both the state and federal levels that support affordability and access.

Investing in Our Communities

 

We also work with nonprofit organizations and other stakeholders throughout the state to address social drivers of health – the non-clinical factors such as access to nutritious food, safe housing, reliable transportation, and financial support health that impact one’s overall well-being. Through the Anthem Blue Cross and Blue Shield Foundation, we invest in organizations working to improve maternal and infant health outcomes, address food insecurity, and support behavioral health and recovery services.

 

Recent grants in New York include:

 

The Child Center of New York for the Perinatal Intensive Outreach Program to address depression and anxiety, enhance mother-infant relationships and reach out to extended families so they can support the mother and baby.

 

Public Health Solutions to support Family Connect EMPATHS: Enhanced Perinatal Mental Health Spectrum of Support Program. The initiative will enable citywide free access to perinatal mental health community support.

 

Samaritan Daytop Village to support recovery by expanding work with an expert Nutrition Wellness Consultant at Peer Alliance Recovery Centers in the Bronx and Queens.

 

Sunset Park Health Council (NYU) to support PEP Talks, a program designed to prevent teen fentanyl overdose. The grant aids the development of a comprehensive Opioid Overdose Prevention Program ensuring high school students are informed and equipped to confront the challenge.

 

Care for the Homeless for the Bronx Health Outreach Initiative, a strategic expansion of the successful program to support the homeless population in the South Bronx.

 

Feeding America for its Food As Medicine initiative to screen patients for food insecurity and connect them to resources. This collaboration between hospital systems and food banks positively impacts specific clinical outcomes around diabetes, cholesterol, and high blood pressure. Participating New York Food Banks: Feeding Westchester, Food Bank for NYC, Island Harvest and Regional Food Bank of NE New York.

 

Working together with policymakers, healthcare providers, and employers, we are on a mission to make healthcare more affordable, accessible, and effective for all New Yorkers.