Hartford Business Journal

HARTFORDBUSINESS.COM | FEBRUARY 19, 2024 19 several years ago looking at primary care investment in all 50 states, and ranked Connecticut last in the nation. It also concluded that increased primary care spending leads to fewer emergency department visits and total hospitalizations, which are major cost drivers. Part of the problem in Connecticut, Hogan said, is that many patients prefer to see specialists first, before a primary care doctor, which leads to fragmented care and higher costs. "Your knee hurts, you go to the orthopedic surgeon. Your heart's palpitating, you got to the cardiolo- gist," Hogan said. Rewarding better outcomes Trinity Health Of New England — which operates several Connecticut hospitals, including St. Francis in Hartford and Johnson Memorial in Stafford — and Anthem declined to share terms of their new contract. But they did describe their efforts to adopt value-based care models. Emily Brower, senior vice president for clin- ical integration and physician services at Trinity Health Of New England, said the value-based care model relies on bringing services closer to patients to improve access. Trinity Health has done that, Brower said, by opening new ambu- latory care centers in the state and investing in telemedicine. Value-based care also puts more emphasis on the prevention and management of chronic health conditions, which can be major drivers of emergency room visits and hospital stays, she said. "If we reduce the need for higher-cost emergent care, we actually return that savings … to our providers," Brower said, in describing how a value-based care model works. "If we're able to reduce the need for care, or deliver that care in a less-costly setting, then some of that savings returns to us. It's shared between us and the payer." Wendy Polsinelli, Anthem's regional vice president of health- care networks in Connecticut, said hospitals and health systems have grown more open to value- based care models since the COVID-19 pandemic. "I think at a high level, it's really rewarding (hospitals) for keeping people healthier versus paying for appointment after appointment," Polsinelli said. Anthem's value-based care program is called Enhanced Personal Health Care, or EPHC. According to Polsinelli, the EPHC program has contracts in Connecticut with 14 accountable care organizations that represent 3,500 primary care physicians. Combined, those physicians treat more than 400,000 patients, she said. She also stressed the important role primary care physicians play in value-based care programs. "Our value-based care models really look to reward doctors and other providers for care coordina- tion," she said. "Primary care is one of the best places to start because we can really see the benefits of value-based care arrangements." A SMALL BUSINESS GIVEAWAY 2024 One Connecticut small business will win a full page ad in the Small Business Issue of HBJ on May 13 and 12 months of free Cash Management Services from TSB. The winner will be notified around April 1st. PRESENTED BY SCAN HERE TO NOMINATE! NOMINATIONS OPEN | JANUARY 15 - MARCH 15 U.S. spending on health care as a percentage of Gross Domestic Product Emily Brower SOURCE: Centers for Medicare & Medicaid Services, Office of the Actuary, National Health Statistics Group 20% 15% 10% 5% 0% 1962 1972 1982 1992 2002 2012 2022 PERCENT OF GDP

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