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Patient-Centered Primary Care Program

PW_E185959
Enhanced Personal Health Care for Primary Care Program is Anthem value-based, patient-centered care program and an important part of Anthem Togetherworks, our name for our provider collaboration work.  
You may sometimes see this program referred to as “Blue Distinction Total Care.” This is the name that some employers, especially those with employees across many states, use to refer to the collection of patient-centered, value-based payment programs that Blue Cross and Blue Shield plans across the country sponsor. For that reason, some of your patients may know the program as Blue Distinction Total Care.  
Enhanced Personal Health Care includes four different types of contract agreements: Enhanced Personal Health Care for Primary Care, Freestanding Patient-Centered Care, and Enhanced Personal Health Care Essentials, along with Comprehensive Primary Care Plus, which is sponsored by the Centers for Medicare and Medicaid Services. All of the Enhanced Personal Health Care agreements include value-based compensation, but also provide support for making changes to the delivery system that drive better care. This support comes in the form of meaningful information, clinical insights and guidance.  
The payment, information and support we offer are meant to support important changes for participating practices. Each program element supports these key elements of patient-centered care: expanded access, shared decision making, proactive health management, coordinated care delivery, adherence to evidence based guidelines and care planning built around the needs of the individual patient. Millions of our members already have benefitted from high-quality, patient-centered care delivered by Enhanced Personal Health Care providers. Supporting materials below are organized by type of Enhanced Personal Health Care contract:  
 
EPHC for Patient Centered Primary Care and EPHC Free-Standing Patient Centered Care Programs
 
These contract arrangements (including CPC+) are for practices with greater than 1,000 attributed Anthem members. The documents below offer detailed descriptions of the programs and resources for participants:  
Program Description – The Program Description provides a detailed description of the Program and its related components. Two versions are included below – one that is in effect today, the other that will be in effect as of the next measurement period.  

Program Description modified 1/1/2017 – Program Description for the Enhanced Personal Health Care Program

Program Description modified 10/1/2017 – Program Description for the Enhanced Personal Health Care Program

 
Measurement Period Handbooks – The Measurement Period Handbooks provide a comprehensive description of the quality and utilization measures and how they are scored. The Measurement Period Handbooks for Commercial business is supplied below.  

Commercial Measurement Period Handbook

 
Program Resources – The tools and information below are designed to support your practice’s transformation as you adopt the patient-centered care model and take on population health management tasks: 

Welcome Packet

Provider Toolkit

Patient Centered Specialty Care Program Pilot

Cost and Quality Resources

Collaborative Learning Opportunities

 
Live webinars, valuable Triple Aim Learning Opportunities and our extensive on-demand recording library.  
 
EPHC Essentials
 
This type of payment arrangement is for practices with fewer than 1,000 attributed Anthem members. The documents below offer detailed descriptions of EPHC Essentials and resources for participants:  
Program Description – The Program Description provides a detailed description of the Program and its related components.  

Program Description effective 1/1/2018 – Program Description for Enhanced Personal Health Care Essentials Program

 
Program Resources – The tools and information below are designed to support your practice’s transformation as you adopt the patient-centered care model and take on population health management tasks:  

Essential Overview Recorded Webinar

Welcome Packet

Practice Essentials Curriculum

Provider Toolkit

Patient Centered Specialty Care Program Pilot

Cost and Quality Resources

Collaborative Learning Opportunities

 
Live webinars, valuable Triple Aim Learning Opportunities and our extensive on-demand recording library. 
 
For more information, e-mail us at VAEPHC@anthem.com.  
In your e-mail, include your name, practice name, tax ID and phone number with area code.  
©2005-2017 copyright of Anthem Insurance Companies, Inc.

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