Anthem Care Comparison

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Anthem Care Comparison
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The growing need for transparency

• Health care affordability is a critical issue
  facing the nation as health care spending reached
  2.2 trillion in 20071
• Providing quality and cost information gives your
  employees a more complete picture, helping them
  to make more effective health care choices

1 Centers for Medicare and Medicaid Services,
Office of the Actuary, National Health Statistics
Group
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Leading with transparency solutions

• Transparency presents meaningful choices for your
  employees
• Actively engages your employees in decisions
• Positively impacts health care outcomes
• Increases the value of health care in
  collaboration with health care providers

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Anthem Care Comparison

• Our goal with Anthem Care Comparison is to
  provide easy-to-use transparency tools to enable
  informed decision-making
• Educate employees about quality measures and
  total treatment costs for the facilities they
  access through our networks
• Show employees how to use this information in the
  decision making process
• Continue to make it easy to navigate and
  understand the tools

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Anthem Care Comparison

• We understand your employees need information
  not just data to help them make their decision.
• Anthem Care Comparison provides quality and cost
  information for common elective procedures (e.g.
  hip replacement, cataract removal)
• Employees rank whats most important to them to
  receive customized results

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Integrating quality information

• Anthem Care Comparison provides measures of
  quality for more than 150 inpatient procedures
  and conditions obtained from state, federal and
  private sources
• Number of patients treated
• Complication rates
• Average length of stay
• Mortality rate

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Using Anthem Care Comparison ? Quality
Step 1 Choose a Procedure
Search by Procedure/Diagnosis
Explanation of Procedure or Condition
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Using Anthem Care Comparison ? Quality
Step 2 Choose Facilities to Compare
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Using Anthem Care Comparison ? Quality
Step 3 Rank Criteria
CHOOSE FACILITIES
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Using Anthem Care Comparison ? Quality
View Summary Results
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Upfront cost information

• Our unique approach provides a range of the
  estimated costs for the inpatient and outpatient
  procedures we report on including our
  discounts.
• Cost estimates include all services that are
  typically a standard part of a procedure or
  treatment
• Using this information, they can estimate the
  approximate out-of-pocket costs for the course of
  treatment before making a decision

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Using Anthem Care Comparison ? Cost and Quality
Certain inpatient procedures have both cost and
quality information
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Anthem Care Comparison ? Cost
Cost information only is available for procedures
under the following headings Diagnostic Tests,
Outpatient Services and Additional Inpatient
Services
Compare costs of various facilities and the
volume of procedures performed
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Transparency in action
Services Interventions
Services Interventions
Summary
Outcomes
Member Jeff31-year-old man who works at a
consulting firm
Symptoms Jeff is a recreational runner and skier.
He injured his knee skiing several years ago, but
the pain and swelling eventually subsided. After
his last 10k race, he started feeling sharp knee
pains. He is concerned about risking further
injury, but he doesnt have a relationship with a
specific physician. Issues Jeff is interested
in understanding his symptoms, treatment options
and taking action, but is not clear where to
start.
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Transparency in action
Services Interventions
Outcomes
Summary
Learns More
Finds a Provider
Considers Surgical Options
Jeff researches his knee problems using
the 360º Health member online services and
learns about potential causes, effects and
treatments.
He logs onto Provider Finder and finds a quality
provider just a few miles from his home.
Through consultation with the physician, it is
determined that surgery is the preferred
treatment.
Again using the 360º Health online services, Jeff
views a video on the procedure to understand the
procedure and its potential risks. He logs onto
Anthem Care Comparison where he obtains general
cost and quality information on different
hospitals. Jeff discusses his research with his
orthopedic surgeon to ensure the best possible
outcome.
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Transparency in action
Outcomes
Summary
Services Interventions

• Reduced cost and improved care
• Jeff selects a high quality, cost-efficient
  facility for surgery.
• Receives care from an experienced hospital
• Saves 9,000 on the total cost of the operation.
  Jeff saves 1,800 out of his own pocket
• He goes into surgery well-informed and prepared
  for recovery, having thoroughly weighed options
  in consultation with his physician.
• Jeff is very satisfied with the quality of care
  and now has increased overall well-being.

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Feedback from our members
YES 84
Anthem Care Comparison is clear and easy to
understand
YES 93
Cost information is valuable to me
Anthem Care Comparison provides information I
cant find elsewhere
YES 80
Number of services performed by a facility helps
me to assess quality
YES 73
This tool increases my ability to make informed
decisions
YES 84
I would recommend this tool to others
YES 86
Source Exit survey of members who have used the
Anthem Comparison Tool
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Anthem Care Comparison Rollout Schedule
ME
WA
Coming in September
MN
NH
NY
WI
MI
CT
PA (w)
OH
NV
IN
VA
CO
CA
KY
MO
GA
Cost data available in all or parts of these
states Quality information is available across
the country
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Experience Anthem Care Comparison

• Member demo available on Anthem.com
• Educational materials available from
• At anthem.com, click the Member tab
• Log into MyAnthem (requires user id/password)
• Click on the 360? Health tab
• Click on Anthem Care Comparison in the left-hand
  menu

Anthem Blue Cross and Blue Shield is the trade
name of In Colorado and Nevada Rocky Mountain
Hospital and Medical Service, 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 New Hampshire Anthem
Health Plans of New Hampshire, Inc. In Ohio
Community Insurance Company. In Virginia
(excluding the City of Fairfax, the Town of
Vienna and the area east of State Route 123.)
Anthem Health Plans of Virginia, Inc. 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.