The new face of health care is beginning to emerge from the corners of the Affordable Care Act, and New Hampshire had its glimpse the past two weeks.

First, Anthem Blue Cross Blue Shield revealed aspects of its Pathway program, developed for the health insurance marketplace, or exchange, and then Harvard-Pilgrim, Dartmouth-Hitchcock Medical Center and Elliot Health Systems rolled out their ElevateHealth plan.

The Pathway program is the backbone of the health plans Anthem will offer beginning Oct. 1 to those buying insurance through the state's electronic marketplace. Anthem is the only health insurer on the state's exchange, although Delta Dental is an approved dental insurer.

ElevateHealth will be available only to employers initially, but is expected to be available on the marketplace in 2015 for individuals. The plan is touted as promoting high-quality health care at a roughly 10 percent lower premium cost.

Anthem says the Pathway program will lower premiums by 25 percent from what individuals could have expected to pay for the additional benefits mandated for exchange policies and to absorb the state's high-risk pool of 3,000 individuals who have been denied private health insurance.

The Harvard-Dartmouth-Elliot project is what is called an Accountable Care Organization (ACO) - integrated health systems that coordinate patient care and chronic-disease management through a "patient-centered medical home" or primary care physician. Something like managed care on steroids.

The idea is to provide better care for less money, and the ACA provides significant up-front money to establish ACOs.

The Pathway program is not technically an ACO, but the concept is pretty much the same because Anthem decided which hospitals and affiliated physician practices and services would be in the network. Not included are some small rural hospitals, the state's two for-profit hospitals in Portsmouth and Derry, Concord Hospital, Southern NH Medical Center in Nashua and Frisbie Memorial Hospital in Rochester.

The Pathway network includes 16 of the state's 26 hospitals, as well as Lahey Clinics.

The Harvard-Dartmouth-Elliot group also includes Southern NH Medical Center, Cheshire Medical Center and New London Hospital.

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Garry Rayno's State House Dome The new face of health care