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IBC, Abington Health, Lumeris to launch Accountable Care Initiative

Will provide unprecedented 360-degree view of patients’ care

Philadelphia, PA – Independence Blue Cross (IBC), Abington Health, and Lumeris announced today the creation of an accountable care initiative using Lumeris’ transformative technology and services to improve the coordination of patient care, lower overall health care costs, and increase patient and physician satisfaction.

This collaboration among a health insurer, a health system, and a health care technology firm is one of the few in the nation and the first-of-its-kind in the Philadelphia region. Through this initiative, Lumeris will aggregate and interpret data from the health insurer and the health system, giving Abington Health and its physicians an unprecedented, comprehensive picture of the care its patients are receiving across the continuum.

Lumeris’ secure cloud-based Accountable Delivery System Platform will combine data from IBC’s Health Informatics — including claims, preauthorizations, hospitalizations, and clinical laboratory results — with data from Abington Health’s electronic medical record system. This will give doctors at Abington a 360-degree view of all the care a patient is receiving. Abington’s physicians will see not only their patients’ data from Abington Health’s physicians and specialists, but also services their patients receive from other network physicians, hospitals, and outpatient surgical centers.

In addition, Lumeris will provide consulting services to Abington Health physicians to help identify transformational opportunities for clinical and financial improvement. This includes creating strategies to predict which patients with chronic conditions are at risk of becoming ill, then jointly developing best practices to help those patients and creating resources to better manage their conditions.

“Independence Blue Cross is proud to be a leader in the new era of accountable care, with progressive programs that help transform the delivery and quality of health care,” said Daniel J. Hilferty, IBC president and CEO. “This initiative with Lumeris and Abington Health advances our organization’s efforts to share real-time data with physicians and hospitals, improve collaboration and coordination, and provide safe, high-quality, and cost-effective care for consumers.”

Last year IBC led the effort with Highmark, Horizon Blue Cross Blue Shield of New Jersey, and Lumeris to acquire NaviNet, the nation’s largest real-time, secure communication network for physicians. As part of IBC and Lumeris’ ongoing partnership with NaviNet, Lumeris will deliver its solution directly to physician desktops via the NaviNet portal. NaviNet speeds and simplifies administrative, financial and clinical transactions among doctors, hospitals and insurers. This initiative marks one of the first uses of the NaviNet network expressly to ease adoption of accountable care.

“We are excited to partner with two of Philadelphia’s leading health care organizations to facilitate data sharing and support their collaborative care goals,” said Mike Long, chairman and CEO of Lumeris. “Along with our strategic partner NaviNet, we are ideally positioned to help their physicians and other stakeholders improve health outcomes, lower costs, increase collaboration, and enhance patient and physician satisfaction.”

“Partnering with IBC in the exchange of timely and more robust patient information will allow us to better provide quality-driven, highly coordinated, integrated health care and supports our mission to improve the health of our community,” says Laurence M. Merlis, president and CEO of Abington Health.

Through this accountable care initiative, the Lumeris solution will help Abington Health fully realize opportunities for incentives under IBC’s industry-leading accountable care payment model, called the Integrated Provider Performance Incentive Plan (IPPIP), an incentive program that rewards doctors and hospitals for delivering higher quality, better coordinated, more efficient care. Lumeris and IBC will evaluate the initiative’s success based on how much Abington Health and its physicians improve their performance on key metrics such as reducing hospital-acquired infection rates and increasing breast cancer screening. The goal is to expand the initiative to other hospitals.

Abington Health Physicians is a network with approximately 200 physicians employed by Abington Memorial Hospital. Its primary care physicians will use Lumeris’ technology to support the more than 30,000 IBC patients they serve, including tracking, monitoring, coordinating, and reporting individual patients’ care or key clinical outcomes for an entire population of patients like those living with heart disease or diabetes.

Abington Health was selected for this initiative since it is among the first health systems to participate in IBC’s innovative accountable care payment model, which IBC pioneered in 2010. In addition, Abington Health employs some of the largest primary care physician practices in the region — more than 80 percent recognized by the NCQA as Level 3 patient-centered medical homes.

Physician groups designated as NCQA medical homes are organized with a physician who leads a team of care managers and health educators to make sure patients, particularly those with chronic illnesses, receive key tests, take medication as directed, and have access to tools and resources to stay well. The goal is to provide more personalized, coordinated, effective, and efficient care for increased physician and patient satisfaction, improved quality, and lower costs. Abington Health has extended its commitment to the initiative by hiring seven care managers to support the program.

“Our physicians are excited about the vast amount of actionable data that can be used to improve the integration and quality of their care,” said Dr. Keith Sweigard, medical director of Abington Health Physicians and Chief of Internal Medicine at Abington Memorial Hospital.“We look forward to being able to improve our patients’ adherence to recommendations for screenings like mammograms and colonoscopies and identify gaps in patient compliance. This comprehensive information will also assist a doctor who is caring for a patient with a chronic disease to ensure the patient receives the preventive care they need by tracking their medical appointments, no matter where they occur, their medicines, and the routine tests they need.”

About Abington Health
Abington Health is the parent organization that encompasses its flagship hospital, Abington Memorial Hospital, in Abington Township and Lansdale Hospital in Hatfield Township. Abington Health also includes two convenient outpatient facilities, Abington Health Center – Schilling Campus in Willow Grove and Abington Health Center – Warminster Campus in Bucks County. Together, these facilities annually serve more than 42,000 inpatients and approximately 131,000 emergency patients.

Also included is Abington Health Physicians, a network of specialists and primary care physicians employed by Abington Memorial Hospital. All told, Abington Health’s medical staff consists of more than 1,400 primary care physicians and medical and surgical specialists, as well as over 125 physicians-in-training within five residency programs. Abington Health employs more than 6,000 employees, making it one of the largest employers in Montgomery County.

About Lumeris
Lumeris provides the solution platform, guidance and operational services necessary for health systems, health plans and provider organizations to transform into high-performing accountable delivery systems. Our revolutionary technology platform for accountable care integrates data from disparate systems across the continuum of care, provides complete visibility into the clinical and financial performance of an enterprise and delivers applications and information to key stakeholders at the point of thought. This improves coordination and enables timely value-based health care decisions that lead to optimal health and cost outcomes. The depth and breadth of our solutions — combined with the company’s extensive real-world experience in accountable care — make Lumeris the ideal partner for any health care organization seeking the significant benefits of a better connected, aligned and informed accountable delivery system.

Karen Godlewski