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Sponsored by: Anthem
July 5, 2023

How Employers, Employees, Providers, and Health Plans Can Work Collaboratively to Lower Healthcare Costs

Dear Connecticut Business Community,

There is no question that healthcare affordability is top of mind for employers and consumers. To achieve the collective goal of more affordable and higher quality healthcare, we must all do our part. Here are four ways employers, employees, providers, and health plans can work collaboratively to lower costs.

Employers

Employers can encourage employees to regularly visit a primary care provider (PCP). PCPs play a valuable role as the first point of contact for patients, which is key to heading off potential medical issues before they become severe – and costly. Alarmingly, studies show declining PCP use in recent years. Employers should work with their health plan to educate employees about ways a PCP can help them achieve better health. Anthem even offers virtual primary care, providing easy access to high quality care on one’s own time.

Employees

Choosing the right healthcare setting to receive care is the easiest way for consumers to reduce costs. One of the most significant and most avoidable out-of-pocket expenses for individuals is an emergency room (ER) visit for a non-life-threatening issue like a minor cut, earache, or allergies. With ER visits costing nearly 10 times compared to urgent care treatment, they are an expensive place for non-emergency care. Employee education about when to use the ER and other lower-cost care settings, including 24/7 telehealth, can be powerful.

Providers

Collaboration with providers is one of the ways health plans can ensure better overall quality of care while also managing costs. At Anthem, we are working to accelerate growth in value-based payment models, which reward doctors and other providers for care coordination, health outcomes, and care experience (such as avoiding unnecessary ER visits and hospitalizations), rather than on the volume of care provided under the traditional fee-for-service system. Anthem’s Enhanced Personal Healthcare program pays providers a clinical coordination fee to fund investments in care coordination and technology that help them better manage their patients’ – our members’ – care and costs. More than 400,000 Anthem members are seen by a doctor within a value-based agreement, and we are working with providers to increase that number because it ultimately means better access to healthcare and lower costs over time for everyone. These partnerships align our network with the common goal of improved quality of care and health of your employees.

Health plans

A health plan’s primary role is to provide consumers with access to care that’s affordable. But how we do that is changing. We have evolved to become more active participants in advancing the health of those we serve, providing tools and data to help members live better lives, help employers access better care for their workforce, help providers deliver better outcomes, and help communities address social drivers of health, like food insecurity.

We know healthcare needs to be a lot more personal and convenient for it to be effective. Tools such as remote patient monitoring, telehealth, virtual primary care, and personal health apps, which can identify gaps in care, access health records, connect to clinicians, and help manage chronic conditions. In addition, at Anthem we leverage our data to provide personalized healthcare that will empower consumers to make more informed decisions about where to get cost-effective care. We use these insights to encourage members to take specific actions to improve their health (for example, sending flu shot reminders).

Protecting healthcare affordability will take collaboration, innovation, and commitment by all of us. As we have for more than 85 years, our team at Anthem Blue Cross and Blue Shield will continue to work with partners like you to lower costs, increase access to care, and improve health outcomes for all in Connecticut.

In good health,
Lou Gianquinto, President, Anthem Blue Cross and Blue Shield in Connecticut