Catholic Medical Partners and Independent Health

Catholic Health, Catholic Medical Partners and Independent Health Join Forces

BUFFALO, N.Y., (October 3, 2012) – Catholic Health, Catholic Medical Partners and Independent Health are joining forces to offer both large- and small-group employers two new products designed to help achieve the Triple Aim of better health, better care and lower costs.

The first of these products – "First Choice" – a self-funded, tiered-network product targeted to large-group employers with approximately 200 employees will be available through Independent Health starting Jan. 1, 2013. It offers a coordinated delivery model that provides employers with the ability to customize their health care coverage based on individual employee needs and the health status of their workforce. Catholic Health introduced First Choice – the first tiered-network product in Western New York – to its own associates in 2009 and to the business community in 2010.

A second, fully insured product targeted to the small-group employer market is expected to be made available in mid-2013.

Officials from all three organizations say these collaborative efforts represent a commitment to work together to bend the medical cost trend through the coordination of patient care and wellness initiatives.

"Independent Health, Catholic Health and Catholic Medical Partners share a common vision for providing patient-centric health care that will continue to establish Western New York as a high-quality, high-performing health care community," said Michael W. Cropp, M.D., president and CEO, Independent Health. "We all recognize achieving this goal requires collaboration and partnerships on initiatives designed to improve quality and customer service, and lower the medical cost trend."

"First Choice is an established product with proven results encompassing the principles of more effective care, with a focus on wellness and prevention," said Joe McDonald, president and CEO, Catholic Health. "Identified savings for First Choice organizations have ranged from 8 to 25 percent, with an average cost savings of 18 percent."

"This partnership represents a new, cutting-edge concept in health care delivery incorporating better, more coordinated care between one of our region's leading health plans and hospital systems, and the more than 900 physicians of Catholic Medical Partners," said Dennis Horrigan, president & CEO, Catholic Medical Partners. "By aligning our physician-hospital leadership we are putting ourselves in the position of greatest potential for improving the delivery of health care."

Benefits of the partnership include:

  • A focus on wellness, prevention and greater personal responsibility, all of which will result in healthier employees, less utilization of costly medical services, less employee absenteeism and a more productive workforce.
  • The integration of pharmacy benefit management (PBM) services with medical services through Pharmacy Benefit Dimensions, which operates as a wholly owned subsidiary of Independent Health, to ensure better oversight and even greater care coordination.
  • Catholic Medical Partners supports embedded care coordinators and other medical management services to assist patients with the greatest burden of illness, and Independent Health will provide its nationally recognized RedShirt Treatment customer service.
  • Employer/employee education programs and vital health screenings will be conducted through Catholic Health.
  • Electronic connectivity – Catholic Medical Partners and Catholic Health are leading the region in electronic health medical records adoption and use, which leads to improved quality and safety. Currently, 90 percent of Catholic Medical Partners' physicians are using electronic medical records, and the organization plans to be completely paperless by 2013.
  • Catholic Medical Partners and Catholic Health provide the largest group of patient-centered medical home practices in Western New York.

"First Choice is a go-to-market product that saves money for those employers who choose it," said McDonald. "We anticipate a high level of interest among businesses for this product because of the combination of lower costs and the greater alignment and coordination of care that comes with it."

"The ability to control health care costs will be the single most important determinant of the economic success of our community – or any community – in the near future," said Dr. Cropp. "Communities that get it right will be the most desirable places to locate business. Helping local employers address one of the biggest costs of doing business will be vital to our economic success as a business and health care community."

Representatives from the three organizations said they began discussing greater collaborative initiatives several years ago in an effort to improve quality and lower the cost of health care.

Those discussions resulted in Catholic Health and Catholic Medical Partners developing a care transitions program aimed at lowering hospital readmissions. This program, which includes home visits and close follow up by the primary care office, has achieved a greater than 40 percent reduction in the 30-day readmission rate for enrolled patients. In addition, Catholic Health and Catholic Medical Partners have created a program which uses embedded nurses within the primary care practice to assist in care of patients with chronic disease. This program has resulted in a decrease in admissions while also improving quality outcomes for patients with diabetes, congestive heart failure and coronary artery disease.

More than 11,000 members will be moving to Independent Health. The First Choice product will be aggressively marketed to employer groups in Western New York.

The First Choice product will include a tiered hospital network with lower patient cost sharing for using Catholic Health services. In addition, First Choice will include all participating physicians in the Independent Health network, which includes the more than 900 Catholic Medical Partners physicians.

The three organizations said a fully insured product targeted to the small-group employer market is being developed for submission to the New York State Department of Finance for approval later this year, with plans to make it available on or about July 1, 2013. They said it will further demonstrate the breadth and depth of their partnership efforts, and result in quality, cost-effective product offerings for employer groups – large and small.

One of the largest providers of healthcare in Western New York, Catholic Health was formed in 1998. Through its more than 8,000 associates and 1,400 physicians, Catholic Health provides care to nearly half-a-million patients across a network of three hospitals on four sites including Mercy Hospital of Buffalo, Kenmore Mercy Hospital and Sisters of Charity Hospital and its St. Joseph Campus. In addition, the system provides comprehensive home care, long-term care, subacute care, primary care and diagnostic services at numerous locations throughout the region. For more information visit www.chsbuffalo.org.

Bringing physician and information together is the foundation of Catholic Medical Partners (CMP). An organization of 900 member physicians, CMP strives to provide its physicians the information and resources they need to better care for their patients. Catholic Medical Partners has invested in technology that is unmatched in Western New York and far ahead of what many other organizations across the county are doing. Its physicians and their clinical staff want patients to be educated, engaged partners in their own care. CMP continues to make tremendous strides in improving overall care management for its patients. Through this collaboration, CMP can provide high-quality, coordinated care for patients throughout the continuum of care-from doctor’s office, to hospital, to home. For more information visit www.catholicmedicalpartners.org.

Headquartered in Buffalo, Independent Health began operations in 1980 and has consistently been rated among the top health plans in the country for customer service and member satisfaction. Independent Health’s comprehensive portfolio of product and service offerings include HMO, POS, PPO and EPO products, Medicare and Medicaid plans, traditional indemnity insurance, consumer-directed plans, coverage for self-funded employers, plus health savings account (HSA) and pharmacy benefit management (PBM) services. Combined, the company provides health benefits and services to nearly 375,000 individuals in Western New York and throughout the country. For more information, visit Independent Health’s website at www.independenthealth.com.