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Cleveland Clinic teams with Lilly and Anthem on heart surgery option for Lilly health plan

The clinic said the program helps keep costs down through better outcomes and bundled pricing while increasing access.

Jeff Lagasse, Associate Editor

(Photo by Rubberball/Nicole Hill/Getty Images)(Photo by Rubberball/Nicole Hill/Getty Images)

Cleveland Clinic boasts of its expertise in cardiac surgery, and now that expertise is available to eligible Eli Lilly and Company employees, retirees and their family members through the Cleveland Clinic Cardiac Concierge Program. 

The new program exists in collaboration with Anthem Blue Cross and Blue Shield and its affiliated health plans, and provides access to cardiac surgery at the Cleveland Clinic Heart, Vascular and Thoracic Institute.

Cleveland Clinic's heart program has ranked as the best in the nation, earning the No. 1 spot in U.S. News & World Report's "2020-21 Best Hospitals" for 26 years running.

WHAT'S THE IMPACT?

The Cleveland Clinic Cardiac Concierge Program is part of Cleveland Clinic's Center of Excellence for cardiac surgery, which seeks to provide high-quality healthcare while also managing costs. 

The program, according to Cleveland Clinic, helps keep costs down through better outcomes and bundled pricing (a single payment that covers a patient's specific treatment over a period of time) while giving plan members greater access to quality care. The program will help Anthem reduce costs through better outcomes and bundled pricing.

Lilly employees and non-Medicare-eligible retirees will pay nothing toward the cost of their surgery after meeting their deductible. Lilly also plans to pay 100% of travel and accommodation expenses for eligible plan participants and a companion to visit Cleveland Clinic. Anthem will arrange travel from the employee's home to Cleveland Clinic and back again.

Launched on Jan. 1, the cardiac concierge program enables participating members to have their care managed by a care coordinator, allowing Lilly families to have one point of contact from pre-surgical appointments through recovery at home. The program also includes a free second opinion for eligible surgeries.

THE LARGER TREND

It's been a busy several months for Cleveland Clinic as it has pursued a number of different partnerships and initiatives. In August 2020, Cleveland Clinic and Aetna formed a new Accountable Care Organization and plan to launch a co-branded commercial insurance plan called the Aetna Whole Health-Cleveland Clinic plan. 

Under the plan, Aetna members can receive care from the Cleveland Clinic Quality Alliance network of employed and independent community physicians or at any Cleveland Clinic facility.

Earlier that year, in May, Cleveland Clinic partnered with United Airlines on disinfection protocols for the safety of passengers and staff. The disinfection and other safety protocols were being offered at no cost to any business looking for help, and did not represent a new revenue stream for the company.

In December, Cleveland Clinic's population health team found a way to deal with the data necessary to target at-risk and vulnerable populations by using algorithms to give them a risk stratification. The clinic developed the risk algorithm using 120 variables from the electronic health record, claims data, and labs and other results to determine the likelihood that someone would encounter a problem.

ON THE RECORD

"Access to high-quality healthcare has an enormous impact on one's health and wellbeing," said Dr. Lars Svensson, chairman of the Cleveland Clinic Sydell and Arnold Miller Family Heart, Vascular & Thoracic Institute. "We are proud to collaborate with Anthem and deliver our top-ranked heart surgery expertise to the employees, retirees and family members of Lilly, no matter where they live."

"We care about the wellbeing of our employees, our retirees and their families, and the impact of increasing healthcare costs," said Steve Fry, senior vice president of human resources at Lilly. "As an innovation-driven company, we are committed to seek solutions that offer high-quality healthcare at more affordable costs."
 

Twitter: @JELagasse
Email the writer: jeff.lagasse@himssmedia.com