Creating Solutions to Change How Health Care Is Delivered

Priorities

It will take big ideas to move the market in the right direction. At Independence Blue Cross, we are poised to have a meaningful, positive influence on the U.S. health care market by:

  • Radically reimagining how consumers pay for health care from treating chronic conditions to fully covering preventive services.
  • Addressing the high cost of prescription drugs through greater transparency and competition. Prescription drugs are currently the greatest driver of health costs affecting consumers, employers, and state and federal budgets.
  • Increasing access to physical and behavioral health services through community collaboration, telehealth, and new technology-based delivery methods.
  • Generating public awareness for the most significant health conditions Americans face today, including:
    1. High blood pressure;
    2. Depression, anxiety, and other mood disorders;
    3. High cholesterol;
    4. Heart disease;
    5. Type II diabetes;
    6. Substance use disorders, including the opioid crisis

Improving quality and reducing costs

Independence is collaborating with area health systems — such as the University of Pennsylvania Health System and Rothman Institute — to reimagine how health care is delivered. Our aim is to build a healthier population by improving the quality of care delivered and reducing health care costs through proactive, coordinated care.

This new way of working together uses the principle of rewarding physicians and hospitals for the quality and outcomes of care they provide, not the quantity. While these reimbursement business models are now gaining acceptance, they are only one piece of our overall strategy.

What sets us apart

Under our new approach, Independence strengthens partnerships with hospitals and physicians in the region by:

  • Working with them on new business models that emphasize shared accountability for the quality and cost of the health care being delivered, rather than the traditional focus on volume. This includes enhanced contracting models that are based on outcomes and data sharing, as well as focusing on improving patient care and health outcomes.
  • Providing robust data that enables them to make better informed decisions that influence appropriate care. For example, providers who participate in value-based programs are given access to a self-service reporting platform called the PEAR portal. The portal gives providers a total picture of the patients they are serving, assists them in identifying trends and cost drivers, and helps them focus on improving their performance.
  • Working closely with them to provide better-coordinated patient care. Independence is empowering health systems and physicians to have ongoing, face-to-face conversations with patients, so they can provide the tools and reports needed to better coordinate care and manage cost efficiencies.

Case Studies

Tandigm HealthSM

Independence cofounded Tandigm Health to work with primary care physicians on a new model of coordinated health care, because stronger primary care can improve patient outcomes and reduce hospitalization rates. Tandigm is engaging with physicians to provide a new level of quality and value for patients.

In 2017, Tandigm’s physicians demonstrated high performance across industry-standard quality measures. Compared to 2016, Tandigm reduced inpatient utilization costs by 11 percent for Medicare Advantage patients and 5 percent for Commercial patients. In that same timeframe, 94 percent of Tandigm’s Medicare Advantage patients received a comprehensive in-person assessment by their physician, improving the quality of their care and enabling Tandigm to reduce hospital admissions for that patient population by 7 percent. Hospital admissions were also reduced by 8 percent for Commercial patients.

Tandigm’s network of more than 420 primary care physicians now care for a population of over 110,000 patients, and Tandigm has more than 180 full-time employees.

We are applying the lessons learned through the Tandigm experience system-wide with our most important provider partners.

Quil

Quil is a joint venture of Independence Blue Cross and Comcast. It is a digital health company that delivers actionable and personalized health itineraries for patients and caregivers, answering the question “What Happens Next?” in their health care journeys. They combine the powers of precision data, state-of-the-art technology, and security with unparalleled consumer reach to help individuals navigate today’s chaotic health care landscape. Headquartered in Philadelphia, PA with additional offices in New York City, Quil serves individuals, health care providers, and payors nationally.

Children’s Hospital of Philadelphia

In June 2020, Independence and Children’s Hospital of Philadelphia signed a new long-term agreement. The agreement represents a shared goal of improving community health care for children and collaborating on quality of care in ways that will benefit children living in the Greater Philadelphia region.

As part of the new agreement, the two organizations will be exploring ways to expand the health care system’s existing value-based program beyond primary care practices. The expanded programs would promote a team-based approach and be designed to engage both organizations to improve quality of care and reduce health care costs for members and patients through better care coordination.

Learn more about the agreement

Cancer Treatment Centers of America Philadelphia

In September 2019, Independence Blue Cross and Cancer Treatment Centers of America Philadelphia, part of a national network of cancer care providers, signed a new four-year agreement. The agreement demonstrates a commitment between Independence and Cancer Treatment Centers of America Philadelphia to provide members and patients with even more access to quality oncology care and related services.

Learn more about the agreement

Trinity Health Mid-Atlantic

In April 2019, Independence and Trinity Health Mid-Atlantic started a new five-year agreement. The agreement — which includes Mercy Fitzgerald Hospital, Mercy Philadelphia Hospital, Nazareth Hospital, St. Mary Medical Center, and Saint Francis Healthcare in Delaware — demonstrates a continued commitment between Independence and Trinity Health Mid-Atlantic to provide members and patients with access to quality, affordable care.

Learn more about the agreement

University of Pennsylvania Health System

In 2017, Independence and the University of Pennsylvania Health System signed an innovative, five-year contract, that strengthened both organizations’ emphasis on coordinated patient care, exchange of critical data, and shared accountability for both quality and cost of care.

The contract also contained a guarantee that neither Independence nor an Independence member will be charged for a hospital readmission within 30 days of an inpatient stay or surgery, a first for the region and among the first nationwide.

After the first year of the contract, the health system reported a 25 percent cut in hospital readmissions, the largest readmission reduction in both organizations’ history.

Learn more about the agreement

Holy Redeemer Health System

Independence and Holy Redeemer have a three-year contract, that makes Holy Redeemer the first community-based health system to participate in the Independence Facilitated Health Networks model. This progressive approach demonstrates the importance of Independence and Holy Redeemer’s long-standing relationship and their commitment to providing high-quality, patient-centered care.

Learn more about the agreement


Jefferson Health

Independence and Jefferson Health are working together to transform the access, quality, experience, and cost of care consumers and patients receive.

A five-year agreement including Jefferson Health’s participation in the Independence Facilitated Health Networks model commits the organizations to work together to provide highly-coordinated, team-based care. It’s the kind of care that will improve access for consumers and patients through innovative technology that monitors progress and allows patients to interact with a caring team of professionals regardless of whether they are at home, in the hospital, or a setting such as JeffConnect®, the largest specialty telehealth initiative in the region. This approach is aimed at improving clinical outcomes, preventing the need for avoidable readmissions, and reducing care costs.

Learn more about the five-year agreement

Rothman Institute

Independence and Rothman Institute recently signed an innovative, five-year contract that illustrates their joint commitment to work closely together to ensure that members are having their procedures and care performed in the most appropriate, high-quality, and cost-effective settings.

Learn more about the five-year agreement

Cardiology Consultants of Philadelphia

Independence and Cardiology Consultants of Philadelphia recently signed a five-year agreement aimed at keeping health care costs down while providing members the highest quality care. The agreement focuses on episodes of care related to chronic cardiac conditions like heart failure, coronary artery disease, and hypertension.

Learn more about the five-year agreement

Premier Orthopaedics

Independence and Premier Orthopaedics recently signed an innovative, five-year contract that illustrates a continued commitment to work closely together to ensure that members are receiving care in the most appropriate, high-quality, and cost-effective settings.

Learn more about the five-year agreement