Company: Anthem Blue Cross and Blue Shield of Indiana
Title: Vice President of Provider Engagement and Contracting
Dr. Lee joined Anthem Blue Cross and Blue Shield in 2001. As Vice President of Provider Engagement and Contracting for the state of Indiana, his responsibilities include: physician and hospital contracting; network development; and optimization of cost of care trends for the state of Indiana. Dr. Lee monitors and analyzes market trends and standards of clinical care in order to plan effective network development programs and strategies.
Approximately six years ago, Anthem launched multiple pay-for-performance pilots in central Indiana with large physician groups. The experience identified several obstacles to optimizing the success of the programs. The obstacles included: difficulty in obtaining clinical data, inadequate penetration of a given physician’s practice, mistrust of the accuracy of the quality reports, and fragmentation of similar programs among various payers. It was recognized that all of the hurdles for a successful pay-for-performance program could be overcome by combining the claims and clinical data from Anthem and CMS and using the Indiana Health Information Exchange to generate the clinical quality reports on individual physicians. The program has evolved into a statewide payment-for-value program involving PCP’s, and it involves clinical data and claims data from multiple payers. The project has been spearheaded by Dr. Lee, and others, and it embraces WellPoint’s strategy by optimizing the quality and affordability of health care.
Dr. Lee graduated magna cum laude from the University of Cincinnati with a BS in chemical engineering and continued his education at Ohio State University, where he earned his medical degree in 1984. He completed his residency in internal medicine at Indiana University, where he was named Resident of the Year, in 1987. He also served as the medical director for MedPrime, a primary care group comprised of about 125 physicians. Before joining Anthem, Dr. Lee practiced Internal medicine with Community Hospitals of Indianapolis. In 1999, Dr. Lee was selected one of America’s top doctors in a survey among doctors of the American Medical Association and published in the national publication, “Guide to Top Doctors”. He was also chosen as one of Indianapolis’ top doctors as published in Indianapolis Monthly magazine in 1998.
Dr. Lee is married and has two sons, Christopher (age 15) and Evan (age 12). He enjoys attending his children’s athletic events and he and his family are active at the Wheeler Mission, an Indianapolis homeless shelter. Dr. Lee serves on the Dean’s Advisory Council for the Indiana University of Informatics. He has also served on the boards of the Juvenile Diabetes Research Foundation and the Wishard Hospital Foundation. His hobbies include running, bicycling and gardening.