The new contract has an effective date of Jan. 1, 2011, and will expand access for an estimated 28,000 Medicaid beneficiaries in south-central
“This is an exciting opportunity and allows our network to move forward with the development of our Accountable Care Organization (ACO) and strengthen our commitment to population health management,” said SFHN Executive Director Jennifer Westfall. “Anthem brings significant resources that will enable us to deliver high-quality and timely care at a more personal level.”
“Effective coordination of care for our members is a cornerstone to our Medicaid program,” said Kevin Hayden, president of state sponsored business for Anthem Blue Cross and Blue Shield. “This new agreement further enhances our ability to ensure our members have greater access to care which complements a variety of care management and preventive programs we offer to help our members stay healthy and manage chronic conditions.”
The agreement will advance the goal of SFHN and its owner – the Mishawaka, Ind.-based Sisters of St. Francis Health Services Inc. – of becoming an ACO.
That’s important as it relates to health-care reform legislation enacted earlier this year, which encourages groups of providers to work closer together to better manage and coordinate the care of their patients. The ACO, thus, operates more efficiently and has the potential to bring down the cost of health care.
Under the new arrangement, Hoosier Healthwise and Healthy Indiana members will continue to see their primary care providers. Guidelines for referrals to specialists will remain the same.
Formed in 1993, SFHN is a nonprofit corporation that coordinates the medical care of more than 35,000 patients. There are more than 400 physicians and ancillary providers in the network. SFHN administers care for patients in health management organizations, preferred provider organizations and employers.
To learn more about St. Francis Health Network, go to www.stfrancishospitals.org/sfhn.
