Anthem-Wellpoint has shown results in two studies on value-based design and chronic care that were recently published. The first, published in Am J Pharm Benefits. 2012;4(1):29-36, shows the results of diabetes patients with waived co-pays for total health management. Participants with waived copayments (n = 237) had significantly greater adherence with diabetes medications compared with controls (medication possession ratio, 0.82 vs 0.77, P = .03). Although total healthcare costs did not differ significantly, members in this program had better comprehensive diabetes care, including more A1C, cholesterol, and kidney function testing. In the cross-sectional study, the reduced copayments cohort (n = 715) had a slightly higher proportion of adherent patients versus the group without copayment reduction (n = 497), but significantly higher healthcare costs. (CHVI comment–this is not unusual in the first year of the VBDesign; by improving care, the total cost of the patient comes down in the 2nd year and beyond). Amirpoor et al, www.ajpblive.com:login:15136
In the 2nd article, Anthem/Wellpoint of Cincinnati has shown improved engagement and outcomes when pharmacy coaching and benefit design are all aligned to manage diabetes. The program showed significant improvement in both diabetes and hypertension. You can find this article at Anthem diabetes-hypertension study from Cincinnati note: it will ask you to download a file called Adobe Air to read the article.