Anthem Care Comparison
The growing need for transparency
Health care affordability is a critical issue
facing the nation as health care spending
reached $2.2 trillion in 20071
Providing quality and cost information gives
your employees a more complete picture,
helping them to make more effective health
care choices
1 Centers for
Medicare and Medicaid Services, Office of the Actuary, National Health Statistics Group
2
Leading with transparency solutions
Transparency presents meaningful
choices for your employees
• Actively engages your employees
in decisions
• Positively impacts health care
outcomes
• Increases the value of health care
in collaboration with health care
providers
3
Anthem Care Comparison
Our goal with Anthem Care Comparison is
to provide easy-to-use transparency tools
to enable informed decision-making
• Educate employees about quality
measures and total treatment costs for the
facilities they access through our
networks
• Show employees how to use this
information in the decision making
process
• Continue to make it easy to navigate and
understand the tools
4
Anthem Care Comparison
We understand your employees need
information – not just data – to help them
make their decision.
• Anthem Care Comparison provides quality
and cost information for common elective
procedures (e.g. hip replacement, cataract
removal)
• Employees rank what’s most important to
them to receive customized results
5
Integrating quality information
Anthem Care Comparison provides
measures of quality for more than
150 inpatient procedures and
conditions obtained from state, federal
and private sources:
• Number of patients treated
• Complication rates
• Average length of stay
• Mortality rate
6
Using Anthem Care Comparison  Quality
Step 1: Choose a Procedure
Search by
Procedure/
Diagnosis
Explanation of
Procedure or
Condition
7
Using Anthem Care Comparison  Quality
Step 2: Choose Facilities to Compare
8
Using Anthem Care Comparison  Quality
Step 3: Rank Criteria
CHOOSE FACILITIES
9
Using Anthem Care Comparison  Quality
View Summary Results
10
Upfront cost information
Our unique approach provides a range of the
estimated costs for the inpatient and
outpatient procedures we report on –
including our discounts.
• Cost estimates include all services that are
typically a standard part of a procedure or
treatment
• Using this information, they can estimate the
approximate out-of-pocket costs for the
course of treatment before making a decision
11
Using Anthem Care Comparison  Cost and Quality
Certain inpatient procedures have both cost and quality information
12
Anthem Care Comparison  Cost
Cost information only is available for procedures under the following
headings: Diagnostic Tests, Outpatient Services and Additional Inpatient
Services
Compare costs of
various facilities
and the volume of
procedures
performed
13
Transparency in action
Summary
Services & Interventions
Outcomes
Member: Jeff
31-year-old man who works at a consulting firm
Symptoms
Jeff is a recreational runner and skier. He injured his
knee skiing several years ago, but the pain and
swelling eventually subsided. After his last 10k race, he
started feeling sharp knee pains.
He is concerned about risking further injury, but he
doesn’t have a relationship with a specific physician.
Issues
Jeff is interested in understanding his symptoms,
treatment options and taking action, but is not clear
where to start.
14
Transparency in action
Services & Interventions
Summary
Learns
More
Finds
a Provider
Considers
Surgical Options
Jeff researches his
knee problems using the
360º Health® member
online services and learns
about potential causes,
effects and treatments.
He logs onto Provider
Finder and finds a quality
provider just a few miles
from his home.
Again using the 360º
Health online services,
Jeff views a video on the
procedure to understand
the procedure and its
potential risks.
Through consultation with
the physician, it is
determined that surgery
is the preferred
treatment.
Outcomes
He logs onto Anthem
Care Comparison where
he obtains general cost
and quality information on
different hospitals.
Jeff discusses his
research with his
orthopedic surgeon to
ensure the best possible
outcome.
15
Transparency in action
Summary
Services & Interventions
Outcomes
Reduced cost and improved care
Jeff selects a high quality, cost-efficient
facility for surgery.
• Receives care from an experienced hospital
• Saves $9,000 on the total cost of the operation.
Jeff saves $1,800 out of his own pocket
He goes into surgery well-informed and
prepared for recovery, having thoroughly
weighed options in consultation with his
physician.
Jeff is very satisfied with the quality of care
and now has increased overall well-being.
16
Feedback from our members
Anthem Care Comparison is clear and easy to understand
YES: 84%
Cost information is valuable to me
YES: 93%
Anthem Care Comparison provides information I can’t
find elsewhere
YES: 80%
Number of services performed by a facility helps me to
assess quality
YES: 73%
This tool increases my ability to make informed decisions
YES: 84%
I would recommend this tool to others
YES: 86%
Source: Exit survey of members who have used the Anthem Comparison Tool
17
Anthem Care Comparison: Rollout Schedule
WA
Coming in
September
MN
WI
MI
OH
NV
CA
NY
PA (w)
ME
NH
CT
IN
CO
MO
KY
VA
GA
Cost data available in all or
parts of these states
Quality information is
available across the country
18
Experience Anthem Care Comparison
Member demo available on Anthem.com
Educational materials available from:
• At anthem.com, click the Member tab
• Log into MyAnthem (requires user id/password)
• Click on the 360 Health tab
• Click on Anthem Care Comparison in the left-hand menu
Anthem Blue Cross and Blue Shield is the trade name of: In Colorado and Nevada: Rocky Mountain Hospital and Medical Service, Inc. In Connecticut: Anthem Health Plans, Inc.
In Indiana: Anthem Insurance Companies, Inc. In Kentucky: Anthem Health Plans of Kentucky, Inc. In Maine: Anthem Health Plans of Maine, Inc. In Missouri (excluding 30
counties in the Kansas City area): RightCHOICE® Managed Care, Inc. (RIT), Healthy Alliance® Life Insurance Company (HALIC), and HMO Missouri, Inc. RIT and certain
affiliates administer non-HMO benefits underwritten by HALIC and HMO benefits underwritten by HMO Missouri, Inc. RIT and certain affiliates only provide administrative
services for self-funded plans and do not underwrite benefits. In New Hampshire: Anthem Health Plans of New Hampshire, Inc. In Ohio: Community Insurance Company. In
Virginia (excluding the City of Fairfax, the Town of Vienna and the area east of State Route 123.): Anthem Health Plans of Virginia, Inc. In Wisconsin: Blue Cross Blue Shield of
Wisconsin ("BCBSWi"), which underwrites or administers the PPO and indemnity policies; Compcare Health Services Insurance Corporation ("Compcare"), which underwrites or
administers the HMO policies; and Compcare and BCBSWi collectively, which underwrite or administer the POS policies. Independent licensees of the Blue Cross and Blue
Shield Association. ® ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross and Blue Shield names and symbols are registered marks of the
Blue Cross and Blue Shield Association.
19