December 03, 2024
Thom Carroll/Philly Voice
The University of Pennsylvania Health System and Independence Blue Cross have reached an agreement on new reimbursement rates for the 400,000 Penn Medicine patients covered by IBX. Above, the Hospital of the University of Pennsylvania.
The University of Pennsylvania Health System and Independence Blue Cross have agreed on new reimbursement rates that will take effect in July, the health care organizations said Tuesday.
The new agreement determines how much the health system receives for services provided to the 400,000 Penn Medicine patients covered by IBX each year. It is part of a larger contract that Penn Medicine and IBX are still finalizing – the fourth between the two entities since 2012. Specific about the rates were not released.
Penn Medicine includes the Hospital of the University of Pennsylvania, Pennsylvania Hospital and Penn Presbyterian Medical Center in Philadelphia and several others elsewhere in Pennsylvania and New Jersey. IBX is the largest health insurer in Southeastern Pennsylvania.
"Our relationship with IBX has allowed us to try new things that have set new standards for our field, like our work together to substantially cut down on preventable readmissions," University of Pennsylvania Health System CEO Kevin B. Mahoney said in a statement. "... Over the years, we've held one another accountable, transformed the way we provide care, and most importantly, we've worked together to make the communities we serve healthier."
The agreement demonstrates an "enduring" collaboration that is "driving transformation by demonstrating that providers and payers can work collaboratively to improve health care for all," said Gregory E. Deavens, president and CEO of Independence Blue Cross.
Under the current contract, Penn Medicine and IBX have a pilot program that eliminates the need for prior authorization for a variety of imaging studies. It's aimed at accelerating scans and diagnoses.
Penn Medicine and IBX also have worked to reduce health disparities through programs designed to "remove unintended discrimination from commonly used tools that help doctors determine the best way to care for their patients," the press release announcing the agreement says.
Under the new contract, Penn Medicine will accept lower reimbursement rates for certain services, regardless of where they are provided. The contract also expands a pilot project that integrates behavioral health services into primary care settings, the Inquirer reported.
