Independence Blue Cross and DaVita HealthCare Partners are launching a new joint venture aiming to personalize, improve and ultimately reduce costs for chronic disease care in one of the country's most expensive healthcare markets.
IBC and DaVita HealthCare Partners, the parent of a dialysis network and a budding healthcare management business, have formed a new company called Tandigm Health that will partner with primary care physicians in greater Philadelphia and offer them payment incentives and coordination and data analytics technologies to focus on high-risk patients with chronic conditions like diabetes, heart failure and pulmonary disease.
IBC CEO Daniel Hilferty argued that greater Philadelphia is one of the best regions to try a new model of primary care, citing a Milliman study finding that hospital admissions in the area are the highest in the nation for people under the age of 65 and 25 percent higher than average.
"This has never been done at this level in Philadelphia and we believe it is the first time in the U.S. [that] an insurer and healthcare provider have structured such a joint venture," Hilferty said in a conference call. "This new company will work in tandem with primary care physicians to create a new paradigm of high-quality, affordable healthcare," he said, alluding the name of the new venture.
DaVita, a publicly-traded company headquartered in Denver, is well known for its vast network of dialysis centers and for one its largest investors, Warren Buffett, who owns about 17 percent of the company's shares. The company has also seen successful business growth in its other division, HealthCare Partners, which manages medical groups and physician networks in California, Nevada, Florida, Arizona and New Mexico, with a coordinated primary care model that IBC executives hope can be applied to care for its members in greater Philly.
"Tandigm Health will be financially and clinically accountable for the health of the patients," said Craig Samitt, MD, CEO of HealthCare Partners. HealthCare Partners will give primary care physicians communications and data tools like predictive modelling and "a network of resources to help patients outside of the doctors office," through partnerships with hospitals, specialists and community-based organizations.
Registered under the DaVita umbrella, Tandigm Health will be led by Anthony Coletta, MD, a surgeon and internist who joined IBC in 2012 as senior vice president after working as chief medical officer at Holy Redeemer Health System and spending 25 years as an attending general surgeon at Bryn Mawr Hospital, now a part of Main Line Health.
"There's a lot of common ground between patient-centered medical homes and the infrastructure that Tandigm Health intends to build," Coletta said, echoing Hilferty, who described PCMHs and ACOs as the body of car and Tandigm as an engine. Coletta said Tandigm hopes to recruit about 300 primary care physicians and internists by 2015 and 700 by 2017.
While the financial incentives "are still a work in progress," Coletta said, the plan is to have Tandigm sign risk agreements with IBC and ask primary care practices add addendums to their IBC contracts. "Our customers are primary care providers," and "physicians should find working with Tandigm Health very attractive," he said. The new model "will let them operate a practice in a way they've yearned for for years."