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    Opinion: Leading change through value-based care

    It's no secret that the U.S. healthcare system is in desperate need of improvement. In fact, according to The Commonwealth Fund's International Health Survey results, the United States ranks last in overall healthcare quality, access, and cost measures in comparison to eleven other industrialized countries. Despite spending trillions of dollars annually to improve the health of our nation, we have not been able to provide the quality of care that U.S. patients deserve.

    After spending two decades as a general surgeon in the Philadelphia area, one of the most expensive healthcare markets in the United States, I saw the problems with the current system firsthand. It became clear to me during this time that there was a need for a new healthcare model to provide physicians with the tools and resources necessary to deliver coordinated, proactive, high-quality care. Specifically, there was, and still is, a need to put primary care physicians (PCPs) back at the center of care. Today, only 30% of all physicians practice primary care. In most other developed countries, PCPs represent 70%, which is reflective of numbers in the United States 50 years ago. Primary care physicians are vital in addressing health problems early and helping patients avoid costly—and often unnecessary—emergency room visits or hospitalization. 

    A positive disruptor

    To address these growing needs within our country’s healthcare landscape, Independence Blue Cross and DaVita Healthcare Partners came together in 2014 to launch Tandigm Health, a value-based healthcare company supporting primary care physicians. After a successful first year in 2015, positive results validate this new model of rewarding doctors for quality care instead of quantity. Tandigm Health was able to lower costs and improve the quality of patient care across a region that truly requires disruptive change—the greater Philadelphia area.

    In its first year, the proactive, high-quality care provided by Tandigm’s network of physicians reduced emergency room visits by 800, cut Medicare costs by 3%, and ultimately reduced healthcare costs in the Philadelphia region by $15 million. Notably, the patient population cared for by Tandigm physicians grew in one year by 30,000 to a total of 100,000 patients and the number of participating physicians was expanded from 270 to 380. While there is still much work to be done in a challenging and uncertain environment, these results demonstrate great promise for the value-based model—in Philadelphia and beyond. The initial success we’ve seen proves the positive impact that proactive primary care can have on a patient population.

    Partnerships and innovation

    Collaborative partnerships are key to success in any industry, but imperative for the evolution of healthcare. Partnering with like-minded local hospitals and physicians is essential to further expand and develop the value-based model. In 2015, we announced agreements with Holy Redeemer/Innovative Wellness Alliance and Doylestown Healthcare Partnership, growing our footprint locally and extending this new model of care to these leading-edge providers.

    There is also great value in investing in new and innovative technology, tools and resources for physicians, to actively improve access, engagement, and health management for their patients. Physicians armed with these tools are able to then receive the right information at the right time in the right format to provide the finest patient care possible. Specifically, we enable our physicians with population management tools, which assist PCPs in identifying and managing patient’s conditions to prevent small problems from becoming larger ones. We’ve also recently expanded our partnership with telemedicine app TouchCare, allowing all 380 Tandigm physicians the ability to securely communicate with patients face-to-face using a mobile device.

    Next: PCPs: the key to success

     

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