Last night, I attended the most unbelievable health insurance industry event in my 20 plus year career. Held at the Grammy Museum in Downtown Los Angeles, Anthem Blue Cross hosted a small group of benefits consultants, agents and brokers to learn about Vivity. Vivity, I discovered may just turn the health insurance industry upside down.
The first clue that this was a different event was when I sat at a table to eat some of the wonderful food. I met a woman who works at UCLA Medical Center. Next to her was a man who works for Cedars-Sinai Medical Center…. Rarely, seldom, never does one meet people from a hospital at a health insurance industry event. This was definitely different.
Next, I had the good fortune of running into Mark Morgan, the dynamic president of Anthem Blue Cross of California. I told him how odd it was to see hospital people at an insurance industry event. He told me about the collaboration that Anthem Blue Cross is doing not only with hospitals but also with other insurance companies. He told me about CalINDEX, where Anthem Blue Cross and Blue Shield will share patient medical records to help doctors and hospitals provide better care for patients. The CalINDEX website says that it will “Provide patients with a seamless transition between health plans or across various healthcare professionals and hospitals.” I interpret that to mean that a doctor could access a patient’s medical records from a central data base – aiding the doctor’s diagnosis and avoiding unnecessary tests. That is amazing. Long overdue. The right thing for sure.
Update September 2021: CalINDEX, merged with another organization and morphed into Manifest Medex. It is still a collaboration between insurance companies, hospitals and medical groups.
The evening event soon went from unbelievable to surreal. Everyone moved from the outdoor terrace to a meeting room with a stage in the Grammy Museum building. There, Pam Kehaly, President of the West Region of Anthem Blue Cross, introduced and shared the stage with three hospital CEOs: Andy Leeka, Good Samaritan Hospital, Los Angeles; Jim West, PIH Health (Whittier Presbyterian Hospital); and Craig Leach, Torrance Memorial Hospital. See the photo below.
In a series of questions and answers they described Vivity, which is a contractual relationship between Anthem Blue Cross and seven of the very best hospitals in Los Angeles:
- Good Samaritan Hospital,
- Huntington Memorial Hospital,
- MemorialCare Health System,
- PIH Health,
- Torrance Memorial Medical Center and
- UCLA Health.
Anthem and the hospitals will share in the risk for an HMO patient population. The hospital execs described how they worked together to reach an agreement where they will share best practices; share risk; and collectively work to improve outcomes for patients. This is a game-changer for health insurance. Right before my eyes I saw the top executives from the top hospitals with the top executive from the top insurance company pledge to offer high quality medical care at lower cost. They described how they have aligned incentives for everyone to provide top patient care. If they can do that cost-effectively, they will share in the savings. If not, they will collectively share in the loss.
As you can imagine, the brokers in the audience had to pinch themselves to make sure that they were not dreaming. We, the brokers, represent the employers and their employees who pay the monthly insurance premium. Our clients pay for all of the doctors, hospitals, MRIs, etc. Everyone wants high quality health care at a low cost. Of course the proof will be in the pudding, as they say. We’ll have to see how Anthem prices the Vivity HMO product and if the hospitals and their medical groups can achieve their goal. We desperately want Vivity to succeed.
When enrollment begins January 1, 2015, Vivity will only be available to large employers with 51+ employees. Anthem anticipates opening this to small group and individual members in the future. As more than one panelist said last night, this is a long term project. The hospitals, medical groups and the insurance company see this as a necessary step in the evolution / transformation of our health care delivery system. I just never thought that I would see it in my lifetime. I am delighted. Good Luck Vivity!
by Bruce Jugan, October 7, 2014