Anthem Blue Cross Blue Shield has five large medical groups participating in its ACO efforts. As a first step in launching the projects, the payer took three years of claims data and downloaded it to the respective databases of the groups, says Antonio Linnares, M.D., medical director at Anthem. The data gave the practices a head start in analyzing patient utilization, Linnares told the audience at the ACO symposium at the HIMSS12 Conference in Las Vegas.
Next, the payer assigned patients to the practices, analyzing its own claims to see who was in need of primary care services. That level of data sharing between payers and providers is critical will be critical for accountable care to succeed, Linnares says.
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