Telehealth use spikes for Medicare Advantage members due to COVID-19
Virtual care use among Anthem's Medicare Advantage (MA) members was 136 times greater in the early months of the pandemic compared to pre-COVID-19 levels. Between March and May 2020, Anthem's MA members used 600,000 virtual health services, compared to 4,400 through the same period in 2019.
Health Affairs paper examines beneficial effects of MA for patients with ESRD
Medicare Advantage (MA) Special Needs Plans (SNPs) are an alternative to traditional Medicare designed to improve care and reduce costs for individuals with End-Stage Renal Disease (ESRD). This analysis found SNP enrollees had lower mortality and lower rates of utilization across the care continuum as compared to fee-for-service enrollees.
Ensuring high quality, more affordable care options for consumers
Over the next decade, the U.S. healthcare system has an opportunity to realize savings of approximately $12 billion if just one in five upper gastrointestinal and colonoscopy procedures move from hospital outpatient departments to ambulatory surgery centers.
Analysis explores potential issues with MA benchmarks for individuals with ESRD
Starting in 2021, Medicare beneficiaries with End-Stage Renal Disease (ESRD) will be able to enroll in any Medicare Advantage (MA) plan. A new analysis funded by the Anthem Public Policy Institute explores some of the potential issues associated with how MA plans are currently paid by the Centers for Medicare & Medicaid Services (CMS) for individuals with ESRD, and identifies possible modifications that CMS or Congress could make to more closely align payment with costs.
Implementing the new MA benefit flexibilities in the CHRONIC Care Act
On January 7, 2020, the head of Anthem’s Public Policy Institute participated in a panel discussion during a public briefing on Medicare Advantage and the CHRONIC Care Act. Discussion centered on opportunities to use new flexibilities to improve care and outcomes for MA enrollees. A recording of the event is available at the link below.
Review of the evidence on competition and price among brand-name drugs
Some experts have proposed combating rising drug prices by promoting brand–brand competition—when multiple brand-name products in the same class are indicated for the same condition. However, numerous reports exist of price increases following the introduction of brand-name competition; this review funded by the Anthem Public Policy Institute helps better understand the interplay between new drug entry and drug prices.
How chronic illness affects public perception of social determinants of health
By better understanding how people with chronic illness view the social determinants of health, payers and care providers can identify new and improved ways to engage with patients. Insights from the Anthem Public Policy Institute inform the discussion.
Advancing the conversation on Medicare Advantage risk adjustment
Takeaways from an expert panel co-sponsored by the Anthem Public Policy Institute suggest using encounter data collected from Medicare Advantage (MA) plans to re-estimate the MA risk adjustment model could make risk scores more accurately reflect the relative costs of providing care in MA. However, likely effects on the broader MA system are unclear.
Study offers new approach to identifying high-cost MA beneficiaries
While there is a growing focus on improving the quality of healthcare delivery for high-cost patients, research has mostly been focused on fee‑for‑service Medicare. New work funded by the Anthem Public Policy Institute explores the clinical composition of high-cost Medicare Advantage populations.
Costs are rising among Medicaid expansion enrollees
The Society of Actuaries’ HealthWatch published research sponsored by the Anthem Public Policy Institute on the experience states and health plans have gained with the Medicaid expansion population. While over 11 million individuals have gained coverage since the expansion began, relatively little has been shared publicly about the enrollment and utilization experience of expansion enrollees.
Anthem is pleased to support the Health Affairs Council on Health Care Spending & Value
The time is right for an evidence-based discussion about what we get for our healthcare spending, whether it is worth it, and what we might realistically do should we collectively determine that there are better ways to spend our limited resources.
Analysis demonstrates value of Chronic Condition Special Needs Plans
Research funded by the Anthem Public Policy Institute found that Medicare beneficiaries with diabetes enrolled in specialized Medicare Advantage (MA) plans called Chronic Condition Special Needs Plans (C‑SNPs) experienced better outcomes than those enrolled in non‑SNP MA plans.
Getting risk adjustment right in the individual market
The affordability and stability of premiums in the individual health insurance market figure prominently in the recent and ongoing debates over national health policy. The Anthem Public Policy Institute co‑sponsored an expert panel to discuss the often overlooked role of risk adjustment and other risk-mitigation measures in promoting both objectives.
Enhancing state flexibility in Medicaid: Early lessons from Indiana HIP 2.0
Many states that expanded Medicaid, as well as many others that did not, are seeking greater flexibility to design their Medicaid benefits in a way that better serves the needs of their residents. The Anthem Public Policy Institute shares early insights from Indiana’s implementation of Medicaid reforms that can inform other states’ efforts.