As Anthem’s vice president of provider enablement, Veeneta Lakhani is leading the company’s effort to work with providers who want to embrace payment transformation but also want a strong solutions partner to help ensure success.

Anthem has made collaboration with providers one of its highest strategic priorities. That strategy has grown beyond offering payment incentives that reward prevention and quality care, to a deeper collaboration in which we foster success by giving doctors and hospitals the support they need to thrive under those arrangements.

Shifting from a system that pays doctors for the volume of care they deliver to one that compensates them for the quality and efficiency of care they provide is not a small task. Anthem is providing doctors and hospitals with the tools and data they need to make this shift, but also prompting the cultural shifts that will make the transformation successful.

“We’re moving from being the payer of claims to the partner that provides solutions across the doctor’s patient base,” says Lakhani. “Provider groups vary dramatically in their level of experience and sophistication with value-based payment programs, so we have to come to the table and meet them where they are to help them on this transformational journey,” she adds.

For example, Anthem provides doctors participating in its value-based health care contracts with free software that flags patients’ missed follow up visits, prescription drug refills and other actionable information. A team of care consultants in every market works full time to help providers apply Anthem’s tools and technology, such as helping to create action plans to successfully identify and reach out to high-risk patients struggling to manage diabetes so that those patients stay healthy, manage blood sugar levels and avoid ER and hospital visits.

Participating provider practices showed fewer members admitted to the hospital: 6 . 1 % Fewer inpatient admits 3 . 4 % Fewer inpatient days

Lakhani and her team are constantly working to analyze member data so participating doctors can identify their high risk patients. In real time, the team can identify practices in which there are opportunities to close a care gap with a patient before it spirals into a major—and costly—medical crisis.

“Instead of leaving patients on their own to deal with the specialist and the labs and the pharmacy, value-based care is about making it easier for the patients to navigate the system—by connecting and coordinating that care,” Lakhani says. Enhanced Personal Health Care is Anthem's umbrella strategy covering all of our patient-centered care and value-based contracting initiatives.

Doctors participating in EPHC (and receiving value-based payments) had $14.08 per member per month, or 3.5 percent, in gross savings in medical costs compared to expected trend as of September 2015. That resulted in $11.34 per member per month in net savings.

Anthem’s family of health plans counts more than 64,000 doctors receiving value-based payments, and the company is committed to having 50 percent of its spending in shared savings and shared risk contracts by the end of 2018, up from more than 43 percent now.

The effort appears to be paying off for members and providers alike. Members who see a primary care doctor participating in Anthem’s value-based payment program rate their overall provider experience higher than members who see a doctor outside the program—noting that they have better communication and access to their doctor outside typical office hours. Their doctors are also more likely to deliver high quality care, making sure that patients get recommended preventive care, such as breast cancer screenings, diabetes eye exams, and measles, mumps and rubella vaccinations.