No event of the past week has greater potential to transform healthcare delivery than the news from California that seven competitive health systems have allied with Anthem Blue Cross to launch a new health plan, Anthem Vivety.
This is a stunning development on several levels. First, Anthem Vivety is thought to represent the first time disparate health systems—all competitors—have joined together with an insurer that does not own them to operate a health maintenance organization.
Second, all hospitals will share in profits and loss along with Anthem Blue Cross, a unit of WellPoint, which recently announced it will shed it’s name and adopt the more consumer-facing name Anthem.
Third, some of the players are better known for premium-priced, high-quality healthcare and not the cut-rate variety, and are not represented on the state’s health insurance exchange, California Covered.
With an avowed target of the Kaiser Permanente organization (which owns an estimated 40% of the California market), the new HMO has plenty of challenges to surmount: data sharing, care coordination and communications, balancing cooperation with competition, and the big one—lowering costs. Anthem Vivety will be priced 10% lower than other plans Anthem offers to employers.
Yes, the alliance will presumably have the benefit of claims data from Anthem, but it’s not as granular as the information available in an EHR and therefore not as valuable. Just how much will the individual systems be willing to share and how will it be formatted into a useable database?
It will be fascinating to watch this new development, which already has a vote of confidence from CALPERS, the nation’s second largest healthcare buyer in the country. Let’s hope it is the beginning of a positive market trend and none of them lose their shirt.