We’re transforming the delivery of health care in our region to make this vision a reality for members, customers, and providers.

The goal: Healthy members and empowered providers, fully supported by the health care system.

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Building a new model of care

Independence is proud to be at the forefront of value-based care.

The value is in the outcome

Through our value-based care model, providers in our network are incentivized to focus on the quality of the care they give. This approach drives more efficient and effective care with better health outcomes.

We are leaders in this work. Today, we have agreements for value-based programs with 90 percent of the health systems and primary care providers in our network that offer services in the Philadelphia five-county region.

In 2021, this equated to approximately $44.8 million in avoided health care costs due to our work with providers to reduce medically unnecessary emergency department visits, avoid readmissions to the hospital, get members to the best and most efficient site of care and helping them avoid complications.

Investing in innovation

Through our Clinical Care Innovation Program, we support providers who are leading the way with powerful approaches to care. These approaches aim to improve health outcomes, break down barriers to care, and drive increased cost efficiency in the system.

Learn more about our value-based care model and Clinical Care Innovation Program.

By investing in unique technologies and companies we are tackling the rising costs of healthcare and medicine.

  • CivicaRX, a new company focused on bringing lower-cost, generic medicines to people across the country. The organization has announced plans to manufacture and distribute insulin by 2024, which will be available to people with diabetes at significantly lower prices than the insulins currently on the market.
  • Dedicated Senior Medical Centers, a leading primary care provider offering personalized and affordable services that improve health for low-income seniors.
  • Evio Pharmacy Solutions, an independent pharmacy solution startup working to improve medication affordability along with patients’ clinical outcomes and medication experiences.
  • PreCheck MyScript, a digital tool that allows network providers to easily determine the most affordable medication options for patients.
  • Synergie Medication Collective, a company focused on improving affordability and access to costly medical benefit drugs.
  • Tandigm Health, a company dedicated to enhancing the ability of physicians to provide the finest possible care while lowering costs through a more coordinated, proactive model.

Giving hospitals and doctors the tools they need for success

Making these models of care successful requires careful planning and collaboration. We work hand-in-hand with the doctors and hospitals in our network. Giving them the tools, data, and support they need to understand their performance and deliver the most effective care benefits to Independence members.

  • We use comprehensive data and analytics, as well as cutting-edge technology, to jointly address important health care issues and proactively manage our members’ whole-health. Learn more about these tools.
  • Our Population Health Specialists are an added layer of support for the doctors and hospitals in our network. They visit providers on-site and offer valuable administrative and clinical support.
  • We have Joint Value Committees established with many of the health care providers in our network. These committees help us all stay coordinated while we work on ways to design innovative approaches to care, improve the quality and efficiency of care, and enhance the member and provider experience.
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A man talks with his therapist

A complete picture of health

The health care system is fragmented, which can make it overwhelming and complicated. At Independence, we offer a model of care that provides the tools needed to navigate through the maze.

  • Chronic and complex condition management gives support to members who are facing ongoing health conditions.
  • Registered nurse health coaches help members, and their families take control of their health and well-being.

  • Behavioral health solutions that provide end-to-end care and give members timely access to high-quality specialized services including child and adolescent services, eating disorders, substance use disorders, and medication management. These solutions include Independence’s own behavioral health customer service/clinical triage services, case management services, provider network, and utilization management services. They also include access to Quartet Health – a company that allows members to self-refer or be referred for care, using a SmartMatch platform to identify mental health resources meeting their needs and preferences from an expanded network of virtual or in person behavioral health providers.
  • Care management and advocacy solutions educate members about their benefits and engage them in their care. They also help members better navigate the health care system.

Impactful results

Together with the providers in our network, we are seeing strong results.

We have been able to reduce unnecessary health care costs through our work with providers to coordinate and facilitate their patients’ healthcare journey and improve our members’ health. In addition, we partner and co-invest with our providers to enhance member access, experience, and outcomes through our Clinical Care Innovation Program. Since the program’s inception in 2020, we have invested more than $4 million to health systems and large specialty groups in our network.

We are already seeing encouraging results that we hope to scale across our network in the future to drive meaningful change.

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Click on an initiative below to view more information.

Independence Population Health Specialists are working with providers in our network to reduce the incidence of late-state liver cancer. Together, we are making proactive outreach to members at risk of liver cancer, encouraging them to be screened. The number of members being screened for liver cancer across Independence’s network has increased by 110% since the program started in 2022.

Penn Medicine’s CareConnect Warmline, a telemedicine-based outreach and navigation service funded by our Clinical Care Innovation Program, guides people through substance use disorder treatment. It focuses on disparities in opioid use disorder treatment, specifically the use of buprenorphine for Black, Indigenous, and other people of color in Philadelphia. Rather than having to meet patients in person, doctors can prescribe buprenorphine via a telehealth visit, making it faster and easier for patients to begin treatment. A case study on this work, published in the New England Journal of Medicine’s Catalyst, noted that 55% of the program’s more than 350 patients stayed on buprenorphine for a month after their initial prescription. Almost 90% filled at least their first buprenorphine prescription, and 69% percent filled at least two.

Trinity Health Mid-Atlantic’s primary care model, Achieving Lasting Improvement via Engagement, sought to improve patient engagement to control chronic kidney disease through nutritional counseling. Patients who received counseling had a significant decrease in body mass index. The decrease was due to better nutrition, exercise, medication management, and education about their disease. The program is funded by a Clinical Care Innovation Grant.

Independence, working with the Penn Integrated Care model, helps provide members with mental health services within a primary care office setting. The model adds a licensed social worker to the primary care team to offer extra support for screening and treatment. The model has helped reduce depression and anxiety in more than 50% of patients who utilized it. This investment in mental health also improved diabetes and blood pressure control as well as total cost of care. Independence is scaling this collaborative acre model across the network based on the positive outcomes.

Together, Caron Treatment Centers and Independence developed a value-based care model that supports and incentivizes the Caron team to deliver effective treatment and aftercare to keep people well and in recovery. Members treated through this program have the lowest rate of readmission within 90 days of discharge compared to all other network substance use treatment providers — and they aren’t simply going somewhere else if they relapse. Our data shows that members are truly less likely to need further residential treatment after participating in the program.

A doctor goes over test results with a woman and her baby