A new health-care first in Philadelphia

op1hilferty20
Taking part in a signing ceremony to mark the agreement between Independence Blue Cross and University of Pennsylvania Health System are from left) Daniel J. Hilferty, Ralph W. Muller, and Anthony V. Coletta, president of Facilitated Health Networks,

The heritage of health care in Philadelphia is among the richest in the United States. We have a great history of health-care “firsts.” The nation’s first hospital was founded here in 1751; the first medical school in 1765; the first children’s hospital in 1855; and the first successful open-heart operation performed with a heart-lung machine in 1953.

Each of these local achievements fundamentally revolutionized health care and helped to establish a tradition of health-care leadership in Philadelphia.

However, in the United States today, medical progress is still rivaled by struggles and inequalities: We have shorter life expectancies, higher rates of disease, and one of the world’s highest infant mortality rates. In Philadelphia alone, the rate of hospital inpatient admissions is more than 31 percent higher than the national average. And costs of health care continue to balloon nationwide — expenditures have risen to 18 percent of our overall economy, the highest of any country in the world.

Bending that cost curve, and improving the nation’s health, are distinctly interrelated priorities.

In the face of these challenges, Independence Blue Cross and the University of Pennsylvania Health System (UPHS) have signed a new five-year contract, after a comprehensive process that led to an exciting — and challenging — slate of better ways to collaborate and innovate. As health-care leaders, we saw this as a moment to come together, re-set, and launch the next generation of health-care “firsts.”

This was the driving force behind UPHS’s decision to join Independence’s Facilitated Health Networks model, which is about shared accountability, the exchange of robust data, and strengthening the coordination of patient care in all we do.

It’s more than a business agreement; it’s a unified promise to the patients we serve across the region.

A cornerstone of our new collaboration is our plan to work together to reduce unexpected hospital admissions, keeping patients with conditions such as heart failure and diabetes cared for at home and in community practices. In fact, we’re so committed to that priority that Penn Medicine has agreed that when a member is readmitted to one of its facilities within 30 days of an admission, Penn Medicine and Independence will treat the admission/readmission as one event.

Penn Medicine has many innovative programs to help us meet this goal, from data science-driven early warning programs to identify patients with heart failure; to telehealth monitoring programs that provide wearable devices to keep new moms safe after they leave the hospitals; to creative prescription drug education and adherence programs that ensure patients are on track with lifesaving medications.

Through our partnership, we’ll exchange data in real time to better identify and understand why and when patients visit specialty physicians, learn more about drug prescribing patterns, and uncover patterns in potentially preventable emergency room visits. Joint care teams will connect Independence staff and Penn Medicine doctors regularly to share findings and best practices.

This isn’t how we’ve worked together before, but it’s how we need to work together moving forward — for the benefit of members who rely on Penn Medicine and Independence for their health and wellness. That’s a responsibility that we take seriously and will continue to deliver on.

It’s also an important “first,” which we hope offers a model — locally and nationwide — for how health systems and insurers can collaborate to provide better quality and coordination of care and combat rising health-care costs for patients and members. Five years from now, we hope that this first is a model that will have been implemented across our region and one that will be seen as critical to transforming health care for all Americans.

And just like so many other health-care innovations, it will have started right here — in Philadelphia.

Daniel J. Hilferty is the president and CEO of Independence Blue Cross.  newsroom@ibx.com
Ralph W. Muller is the chief executive officer of the University of Pennsylvania Health System. pennmedicinecommunications@uphs.upenn.edu