Philadelphia – Independence Blue Cross (Independence) and University of Pennsylvania Health System (UPHS) have signed an innovative, five-year contract that strengthens both organizations’ emphasis on coordinated patient care, exchange of critical data, and shared accountability for both quality and cost of care. UPHS has also officially joined the new Independence Facilitated Health Networks (FHN) model, which is designed to engage both the insurer and the health care provider to improve quality of care and reduce health care costs for Independence members through better care coordination.
“We are extremely pleased that the University of Pennsylvania Health System, an institution recognized internationally for superior care, shares our commitment to innovate on behalf of our members and is demonstrating that commitment through a new contract that includes the Independence Facilitated Health Networks model,” said Daniel J. Hilferty, president and CEO at Independence Blue Cross. “This is a significant advancement in how we collaborate with hospitals and doctors to ensure our members, and the community-at-large, receive quality care at an affordable price. The leadership exhibited by Ralph Muller and his organization is a major step in improving how the health care system works in our region. All of us at Independence are excited to embark on this important journey with such a respected partner.”
The new contract introduces significant collaboration and innovation on behalf of patients and includes things such as:
- Shared accountability between the health insurer and health care provider for the quality and cost of the care being delivered. The two organizations worked together to design enhanced payment models that facilitate improved patient care and health outcomes. For example, under the new contract, UPHS is providing Independence members with a 30-day readmission guarantee on all inpatient services and surgeries. This enhances patient monitoring and coordination of services immediately following discharge from the hospital.
- The exchange of real-time data that enables physicians to make more informed decisions on appropriate care. Data exchanged with UPHS will include critical issues such as specialist and facility utilization, drug prescribing patterns and potentially preventable emergency room visits. Combining claims data with electronic medical records will create a two-way exchange that provides Independence and UPHS a complete view of patients’ health issues and help identify – and fill – gaps in care.
- Strengthening efficiency and coordination of patient care through collaborative assessment. Under the Independence FHN model, an Independence Clinical Care Transformation team will work in-person and on-site with UPHS doctors, bringing tools and reports to help them manage cost efficiencies. New information provided will include comparative cost ranking – low, middle, and high – for frequently performed procedures, while providing a holistic view of the population of patients served by UPHS. Another important new collaboration will be care groups developed through the Clinical Care Transformation team. These groups will include Independence staff and UPHS staff and doctors and meet quarterly to share best practices.
“At every step in our work to improve patient care, Independence has been an important collaborator. Now, we’re taking the next step together, as the nation’s ‘best in class’ partnership between health systems and insurers,” said Ralph W. Muller, CEO of the University of Pennsylvania Health System. “Every day, our physicians and staff at Penn Medicine will be working together with our colleagues at Independence to improve quality of care, decrease costs of providing it, and most importantly, putting all of that together to keep our patients healthy.”
“The University of Pennsylvania Health System is known for world class treatment, technology and care delivery,” said Anthony V. Coletta, M.D., MBA, president of Facilitated Health Networks at Independence Blue Cross. “We are delighted to be partnering with them on this exciting new contract. This collaborative approach and shared accountability that engages, enables, and empowers providers to deliver quality, affordable care underscores where the health care industry is moving and Independence is eager to help lead the way with Penn.”
The contract, effective July 1, 2017, will include the following facilities and physician practice groups:
- Hospital of the University of Pennsylvania
- Pennsylvania Hospital
- Penn Presbyterian Medical Center
- Chester County Hospital
- Clinical Practices of the University of Pennsylvania
- Penn Medicine Clinical Care Associates
- Clinical Health Care Associates
- Skilled nursing facilities
- Home infusion
- Ambulatory service centers
- Ambulance services