ST. LOUIS - To address growing employer and consumer demand for high quality, more affordable health care, Mercy and Anthem Blue Cross and Blue Shield in Missouri (Anthem) have entered into a cooperative care agreement that promises improved health, lower costs and a better overall patient experience. The collaboration will unite Mercy’s high-performance care delivery network and Anthem’s Cooperative Care value-based care reimbursement model to create an arrangement in Missouri that will benefit health care consumers and employers by aligning incentives to successfully drive the highest quality results at a lower cost.
“We must think differently about access to care, especially after seeing the impact of COVID-19,” said Shannon Sock, Mercy executive vice president of strategy and CFO. “Our patients want easy and convenient care 24/7, whether digital, virtual or in medical clinics and hospitals. Working with Anthem, we’re able to reach our patients where they are and keep them connected and safe. We’re leveraging extensive data insights so we can intervene earlier, closing gaps and improving the health and care experience of patients while working to lower costs.”
The new agreement builds on an earlier Mercy and Anthem collaboration to transform health care across Missouri. Mercy has been a long-time participant and one of the nation’s best integrated providers in Anthem’s Enhanced Personal Health Care program, a value-based care reimbursement model that measures and financially rewards improved health results and efficiency. The new Cooperative Care agreement takes that methodology one step further by incorporating activities to improve the patient experience, increase data flow between Mercy and Anthem and more fully align financial incentives. Through the model, reimbursement to Mercy providers correlates to results-based quality metrics and patient satisfaction.
“As we continue our work to improve access to high quality and affordable health care, we are pleased to work with one of our leading providers. This model leverages the strengths of two leading health care organizations that are deeply committed to Missouri,” said Amadou Yattassaye, president of Anthem Blue Cross and Blue Shield in Missouri. “This highly collaborative model provides a reimbursement structure and data flow that enables primary care physicians and specialists to coordinate more closely, close gaps in care and optimize results. This is a first-of-its-kind model in Missouri that we hope will continue to grow.”
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Mercy, one of the 15 largest U.S. health systems and named the top large system in the U.S. for excellent patient experience by NRC Health, serves millions annually with nationally recognized care and one of the nation’s largest and highest performing Accountable Care Organizations in quality and cost. Mercy is a highly integrated, multi-state health care system including 50 acute care and specialty (heart, children’s, orthopedic and rehab) hospitals, convenient and urgent care locations, imaging centers and pharmacies. Mercy has over 1,000 physician practice locations and outpatient facilities, more than 5,000 physicians and advanced practitioners and more than 50,000 co-workers serving patients and families across Arkansas, Illinois, Kansas, Missouri and Oklahoma. Mercy also has clinics, outpatient services and outreach ministries in Arkansas, Louisiana, Mississippi and Texas. In fiscal year 2023 alone, Mercy provided more than half a billion dollars of free care and other community benefits, including traditional charity care and unreimbursed Medicaid.
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About Anthem Blue Cross and Blue Shield
In Missouri (excluding 30 counties in the Kansas City area) Anthem Blue Cross and Blue Shield is the trade name of 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. 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 Blue Shield Association. Additional information about Anthem Blue Cross and Blue Shield in Missouri is available at anthem.com. Also, follow us on Twitter at twitter.com/anthemBCBS and on Facebook at facebook.com/AnthemBlueCrossBlueShield.
