Independence Blue Cross and Crozer-Keystone Health System Seal Three-Year Contract Renewal
Philadelphia, PA - November 3, 2011 - Independence Blue Cross (IBC) announced it has renewed a three-year contract agreement with the Crozer-Keystone Health System that will include IBC's new hospital/physician incentive program to help improve quality of care and lower costs for consumers.
The agreement with Crozer-Keystone that went into effect on July 1, 2011, ensures IBC members continued access to covered services at the health system's flagship hospital, Crozer Chester Medical Center, as well as Community Hospital, Delaware County Memorial Hospital, Springfield Hospital, and Taylor Hospital, its outpatient facilities, and comprehensive physician network of approximately more than 350 primary-care and specialty practices.
Under this agreement, Crozer-Keystone Health System-one of the largest employers and providers of health care services in Delaware County- has committed to implementing IBC's integrated provider performance incentive plan (IPPIP). Crozer-Keystone is among the early adopters of health care institutions in the Philadelphia region to embrace this innovative payment design. The framework for IBC's new hospital/physician incentive program is aligned with an initiative in the new federal health reform law that will begin to move today's fragmented health care system into an era of integrated, so called accountable care.
"We have joined with Crozer Keystone Health System on a progressive pay for performance approach to hospital and physician reimbursement through our new incentive program," said Daniel J. Hilferty, president and CEO of Independence Blue Cross. "Through our strong relationship with Crozer-Keystone Health System, and industry leaders like Joan Richards, we are creating a new model of health care using innovative payment strategies and advances in health information technology to improve the quality of care and lower costs for the communities we serve."
"Crozer-Keystone Health System is committed to producing excellent outcomes for patients while lowering health care costs," said Joan K. Richards, president and CEO, Crozer-Keystone Health System. "The key to achieving these goals is a strong primary care physician network focused on the aggressive management of chronic disease and the provision of preventive services. All of our doctors, specialists, nurses and other care providers are focused on providing our patients safe, high quality care. Achieving better clinical outcomes at lower costs benefit not just individual patients, but our whole community. We look forward to partnering with Independence Blue Cross in this effort."
The IPPIP program, which promotes greater integration between hospitals and physicians, complements Crozer-Keystone's efforts to improve care coordination, access and quality through its primary care physician network's use of the medical home. As a medical home, primary care practices serve as the central source for patient health care needs by coordinating and integrating any communication or appointments with other specialists, maintaining electronic medical records, prompting follow up visits, and developing strong relationships with patients.
Equally transformational, is the movement in today's health care system to adopt a new model of accountable care, where groups of physicians, specialists, hospitals, and other health care providers work together to coordinate care for the patients they serve and share responsibility for providing efficient, high-quality care. These groups must be large enough to set up comprehensive performance measurements and have the capability of tracking and analyzing costs and resource needs.
Similarly, IBC's new incentive plan provides hospitals and their affiliated participating physicians with additional financial rewards for delivering better health outcomes and lowering medical costs. Fifty percent of the potential earnings for the hospital and physicians are based on their ability to improve their performance related to hospital acquired infections and readmissions, and to ensure evidence based guidelines are followed for surgical care and for the treatment of heart attacks, heart failure, and pneumonia. The other fifty percent of the potential incentive payment is based on their ability to manage costs through greater collaboration and coordination of inpatient, outpatient, ancillary care, home health, prescriptions, and other health services.
"Our IPPIP program is intended to recognize and reward high performing hospitals and physicians," says Doug Chaet, senior vice president of IBC's Contracting and Provider Networks. "In this shared savings arrangement, provider performance and the corresponding reward are based on their degree of improvement when compared to providers' historical baseline. The amount of shared savings can be 30 percent, 40 percent, or 50 percent depending on the degree of improvement."
About Crozer-Keystone Health System
Established in 1990, Crozer-Keystone Health System is the largest employer and provider of health-care services in Delaware County. The system provides a full spectrum of wellness, prevention, acute care, rehabilitation and restorative care to the community. The health system comprises five hospitals, a comprehensive physician network of primary-care and specialty practices, the Crozer-Keystone Sleep Centers and the Healthplex Sports Club. The Health System provides a trauma center, a regional burn center, two regional cancer centers, and a fertility center, among its many specialty services.
About Independence Blue Cross
Independence Blue Cross is a leading health insurer in Southeastern Pennsylvania. IBC and its affiliates provide coverage to nearly 3.1 million people. For 73 years, Independence Blue Cross has offered high-quality health care coverage tailored to meet the changing needs of members, employers, and health care professionals. Independence Blue Cross is an independent licensee of the Blue Cross Blue Shield Association, an association of independent Blue Cross and Blue Shield plans.