A new joint venture between Independence Blue Cross and DaVita HealthCare Partners
aims to improve primary care
and lower costs in Philadelphia by providing data, resources and financial incentives to doctors to help them take better care of patients with chronic diseases.
The primary-care physicians
who belong to the Independence Blue Cross network and who opt into the venture, which is called Tandigm Health, will have access to care technology developed by DaVita HealthCare Partners, which operates medical groups in five states. They will also receive data, additional support and resources for patients to receive care outside of the doctor's office to keep more of these patients out of the hospital.
In exchange for their participation in Tandigm Health, the physicians will receive financial incentives for improving the quality of care. Independence Blue Cross expects to see costs go down as the quantity of care diminishes. During a call with reporters, executives declined to outline the planned physician financial incentives.
“Tandigm Health will reward doctors for the quality of care they provide, not the quantity of care,” said Dr. Craig Samitt, president and CEO of HealthCare Partners. “This creates an incentive system based on improving quality and lowering costs that benefits everyone: patients, doctors, hospitals and the community.”
The joint venture hopes to enroll 300 physicians by 2015 and up to 700 within five years. Most of the physicians who are expected to participate in Tandigm Health will be part of independent physician practices. That runs counter to the trend in recent years of more physician groups being acquired by hospitals and health plans.
When DaVita HealthCare Partners has gone into new markets through acquisitions of medical groups, the first step is usually to align the company with an insurer
, Samitt said. Now the company also is looking at entering new markets through partnerships with health plans that are similar to Tandigm Health. This is DaVita HealthCare Partners' first joint venture with a health insurer.
“The vertical integration model has limitations,” Samitt said. “When those acquisitions occur, the acquiring organization is put in a more dominant and historical restrictive position.”
The Philadelphia healthcare market has high utilization
and high costs. It also has many hospitals and specialists but there are fewer primary-care physicians in the mix. Hospital admissions in the region for people under 65 are the highest among the nation's largest metropolitan areas and 25% higher than the national average, according to data provided by Milliman.
The venture will help “strengthen primary care at a time when it's needed, but it's doing it with the physicians,” said Dr. Steve Udvarhelyi, executive vice president of health services and chief strategy officer for Independence Blue Cross.
Dr. Anthony Coletta, most recently senior vice president at Independence Blue Cross and a former chief medical officer at Holy Redeemer Health System in Huntingdon Valley, Pa., has been named president and CEO of Tandigm Health. Follow Jaimy Lee on Twitter: @MHjlee