Changing Lives

Together
Our Vision
We’re not just another health benefits plan.
We help to improve members’ lives
– We are an ally with the community and providers
– Our local presence improves understanding
– We have a diverse staff for a diverse member base
– We believe “We Can Help!”
 About Anthem Health Plan

• Anthem is a proven model that

serves low-income and/or medically
high-risk individuals enrolled in
Medicaid, State Children’s Health
Insurance Programs and other
publicly funded health care programs.
• We serve more than 2 million
members and are backed by
more than 10 years of experience
in publicly funded health care
programs through our affiliated plans
throughout the nation.
• We address the cultural needs of
our members and the community
through access to quality care offered
by a choice of providers and access to
numerous value-added services.
 The Unique Experience of Anthem
• The needs of Medicaid and SCHIP members
are unique.
• We develop programs to help our members reduce
health risks through better self care.
• Among these programs are:
– ER initiative that reduces inappropriate ER
use and promotes doctor visits
– Childhood obesity programs
– Asthma program
– Well-child/well-mother care
– Smoking cessation
 Anthem Unites Everyone Involved
Look at the Big Picture

Government
Government Agencies
State and County
Health Departments
County Medical Health

Provider
Community Contracting
Advocacy Groups Customer Education
Schools Problem Solving
Community Leaders
Resource
Center Quality of Care Initiatives
Social Service Agencies
Religious Organizations

Member
Coverage
Education
Transportation
Health Education
Access to Care
What Is a Community Resource Center?
Anthem’s Hands and Heart in the Community

• Building strong
provider-member relations
• Offering health education
classes and materials
• Reaching those who may have
difficulty obtaining care
• Furnishing providers with
training, including Medicaid
guidelines and changes in state
procedures
• Working with members,
government, providers and
communities to help improve
the health and lives of
low-income families and
individuals
 Community Resource Center Staff
The People Who Help You Make a Difference

• Director/Manager
• Manager, Network Development
• Clinical Quality Administrator
• Health Promotions Consultant
• Outreach Specialist
• Network Education Representative
• Administrative Assistant
 Community Resource Center
Value for Our Members

Who are the Anthem members our Community Resource

Center serves?
• Individuals and families
– Often unemployed or unable to afford health coverage
– Often temporary asssistance for needy families (TANF)
or welfare recipients
• Those who have barriers to communication and care
– High percentage of non-English speaking
– High percentage of low-literacy rates
– Often lack trust in the
health care system
• People dealing
with hardships
– Untreated illness
– Loss of a place
to live
– Spousal abuse
 Community Resource Center
Value for Our Members

How our Community Resource Center helps:

• Links members to other publicly funded programs
• Assists in the member’s native language
• Connects them to free health education classes
and programs
• Arranges appointments and/or transportation
• Encourages healthier lifestyle choices
 Community Resource Center
Value for Providers

Who are the providers that serve Anthem members?

• May be traditional Medicaid providers (Medicaid and
SCHIP members only)
• Federally Qualified Health Clinics (FQHCs) and
Rural Health Centers (RHCs)
• Include commercial health benefit plan providers
How do we help providers?
• We offer in-person service through local CRC staff
• We train them on plan benefits, billing and claims
• Encourage members
to keep medical
appointments
• We play a key role in
case management
 Community Resource Center
Value for Community Based Organizations (CBOs)

What are Community Based Organizations?

• Nonprofit groups, social services, faith-based and
charitable institutions
• Groups that strive to make a difference in
the community
• Groups that often represent interests of
the underserved
How our Community Resource Center helps:
• Links Anthem members to CBOs for
appropriate assistance
• Encourages CBOs to educate their members on
Anthem and Medicaid
• Honors select CBOs for their achievements
with Community Service Awards
 Delivering Health Education
and Programs
Community Resource Centers offer and promote:
• Self-Care Initiative (ER Diversion Program)
• Well-Woman Care
• Get Up and Get Moving!
• The Last Cigarette (TLC)
• Healthy Habits Count With Asthma
 Community Resource Centers,
State Agencies and Vendors
Local support promotes education,
compliance, health initiatives and
solid working relationships with:
• Department of Health and
Medicaid agencies
• Enrollment brokers
• County social services
and health offices
 We All Need One Another
To help us improve the lives of our members and the
health of our communities, our Community Resource
Centers in your community and across the nation can
work with you to make a difference.

Member

Our Community
Community Resource Centers Provider
Can Help!

Government
 From Anthem and Our
Community Resource Center

Thank You!

In Connecticut, Anthem Blue Cross and Blue Shield is a trade name of Anthem Health Plans, Inc., an independent licensee of the Blue Cross and Blue Shield Association.
In Indiana, Anthem Insurance Companies Inc., dba Anthem Blue Cross and Blue Shield, is an independent licensee of the Blue Cross and Blue Shield Association.
In Nevada, HMO Colorado, Inc., dba Anthem Blue Cross and Blue Shield Partnership Plan, is an independent licensee of the Blue Cross and Blue Shield Association.
In Ohio, Anthem Blue Cross Blue Shield Partnership Plan, Inc. is an independent licensee of the Blue Cross and Blue Shield Association. ® Registered marks Blue Cross
and Blue Shield Association. 0607 AN0014758 6/07