Dive Brief:
- Anthem Blue Cross and Blue Shield plans in Ohio and 13 other states became the first health plans to offer providers incentives for getting integrated care certification (ICC) from the Joint Commission.
- The certification will help Anthem meet its care coordination measure under its Quality-In-Sights hospital incentive program, its performance-based reimbursement program for hospitals.
- Approximately 800 hospitals and 38 million people are affected by the move, Anthem spokeswoman Joyzelle Davis told Modern Healthcare.
Dive Insight:
To date, only one Florida hospital, Parrish Medical Center, has attained integrated care certification. No Anthem hospitals have received ICC, but Anthem hopes its recognition of the standard will prompt hospitals to do so.
The decision underscores a broader press by CMS to reimburse based on quality, not quantity. Among CMS’ initiatives is a proposed bundled payment model for heart attacks and bypass surgeries. A demonstration project is expected to launch at 98 sites in July 2017.
The Joint Commission launched the ICC a year ago to recognize providers that excel at communication, information sharing and other behaviors aimed at creating a seamless experience for the patient across multiple healthcare settings.
To be eligible for certification, at least one unit of the hospital, such as ambulatory care, must have Joint Commission accreditation. Those that pass a review by integrated care specialists receive three years’ certification.