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Patient-Centered Primary Care Program

Anthem is excited to announce the launch of the Enhanced Personal Health Care Program (the Program). This Program empowers primary care physicians (PCPs) to engage in those comprehensive primary care functions that move us toward a coordinated, evidence-based care model that has the greatest impact on achieving the triple aim of improved quality, patient experience and affordability.  
The Program includes our own Anthem-specific Enhanced Personal Health Care Program as well as the Comprehensive Primary Care (CPC) initiative (collectively, the Program). CPC is an effort by the Centers for Medicare and Medicaid Services (CMS) to align multiple payers around select physician practices in specific geographic areas for the purpose of transforming payment and practice redesign.  
We believe the doctor-patient relationship is the most important in health care. Every patient should have a relationship with a primary care physician who knows and understands their individual health care needs, can provide comprehensive “whole patient” health care services, and will serve as their champion, helping them navigate the complex health care system to ensure they get the care they need when and where they need it. This is the key to improving quality and outcomes and, subsequently, lowering costs.  
Our Program is based on a simple principle – that primary care physicians and their practice team, provided with the right tools, information, and resources, are best equipped to optimize the health of their patients and improve the affordability of health care. This Program will: 
Make a significant investment in primary care that allows primary care physicians and their practice team to do what they can do best: manage all aspects of their patients’ care.
Provide primary care physicians with tools, resources and meaningful information that promote (1) access, (2) shared decision making, (3) proactive health management, (4) coordinated care delivery, (5) adherence to evidence based guidelines and (6) care planning built around the needs of the individual patient, leading to improved quality and affordability for our customers and their patients.
Help redesign the current payment model to move from volume based to value based payment, aligning financial incentives and providing financial support for activities and resources that focus on care coordination, individual patient care planning, patient outreach and quality improvement.
Improve the patient experience by:

creating better access to a primary care physician who will not only care for their “whole person” but will become their health care champion and help them navigate through the complex health care system,

making them active participants in their health care through shared decision making, and

optimizing their health.

Webinars Are Available!  
If you’d like a comprehensive overview of the Program, webinars are available for you to attend. View webinar availability
Program Description  
For a more complete description of the Program, access the Program Description via the following links: 
Program Description modified 7/1/2016 – Program Description for the Enhanced Personal Health Care Program  
Program Description modified 1/1/2016 – Program Description for the Enhanced Personal Health Care Program  
For a comprehensive description of the quality and utilization measures and how they are scored, access an example of the Measurement Period Handbook. If your organization participates in the Program, a copy of the Measurement Period Handbook that is specific to your Measurement Period will be distributed to your practice approximately 90 days prior to the start of the Measurement Period. 
Program Topics  
To learn more about specific Program topics, access these links below:  
Medical Panels
Patient Centered Specialty Care Program Pilot
Program Resources 
Additional resources to assist in transforming your practice for the Program.  
For more information, e-mail us at VAPrimaryCareProgram@anthem.com.  
In your e-mail, include your name, practice name, tax ID and phone number with area code.  
You can also reach any of your practices’ key contacts directly using this Support Role Directory.  
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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