Anthem Blue Cross Collaborates With Sharp's Medical Groups on New Program for San Diego PPO Plan Members

SAN DIEGO, Calif. — Anthem Blue Cross, Sharp Community Medical Group and Sharp Rees-Stealy Medical Centers announced they are collaborating on a pilot program designed to provide coordinated, seamless medical care to select Anthem PPO members through an Accountable Care Organization (ACO). The hallmark of this ACO approach, offered in San Diego, is a focus on high-quality care and collaboration among physicians and the health plan to improve health outcomes, patient satisfaction and value.

Under a traditional PPO plan, patients may choose to receive care from many physicians from different provider networks. Under this new ACO arrangement, there will be strong emphasis on coordination of care among all the health care providers involved in the ACO initiative, which includes an enhanced focus on preventive care and chronic care management.

The ACO pilot program is being offered to select Anthem Blue Cross small group, large group and individual commercial PPO members in the San Diego region where Sharp Community Medical Group and Sharp Rees-Stealy Medical Centers physicians are based. The members are included in the program if they have received the majority of their medical care from these same treating physicians in the past, so there is already a strong physician-patient relationship. In most cases the member's dependents will also be included in the program. Through the ACO, the physician becomes a true partner in working with the patient on his/her overall care.

"Individuals who receive coordinated, patient-centered care through an informed collaborative partnership with their physicians can more effectively manage their health care needs," said Pam Kehaly, president of Anthem Blue Cross. "This integrated team collectively takes responsibility for the ongoing care of patients, thus helping them live healthier lives and reducing the cost of care."

"We bring many years of experience providing outstanding health care and great value to our patients," said Dr. Donald C. Balfour III, president and medical director of Sharp Rees-Stealy Medical Group. "We are pleased to have been selected by Anthem to participate in this pilot."

According to Dr. John Jenrette, CEO and medical director of Sharp Community Medical Group, "Under this exciting new ACO program, PPO patients will now have the opportunity to have their personal doctor help them navigate the often-confusing array of health care options and better coordinate their care." 

Last Updated: September 29, 2011