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Introducing new cost and quality transparency tools and features

November 1, 2012

Due to the rapid growth in consumer-driven health plans and provider incentive programs, IBC must become more transparent by increasing the availability and accessibility of health information and data. With that, we are pleased to announce the launch of new provider cost and quality transparency tools and features for commercial and Medicare Advantage HMO and PPO members, including those who carry an Independence Administrators ID card, and participating providers. Over the next few months and throughout 2013, new tools and features will be released to assist IBC members in becoming more informed consumers and managing their health benefits. In addition, these tools will assist providers as they strive to become more accountable for the cost and quality of care being delivered.

Member-facing tools

The following new tools and features will be released in December 2012: Search for a Doctor, Hospital, or Other Medical Facility. This new, easy-to-use tool will more efficiently assist members in their online search of the doctors, specialists, hospitals, and other health care professionals who participate in IBC?s network. Patient Review of Physicians. This new feature will allow IBC members to read and write physician reviews regarding their experiences and care received from physicians. Members will be able to view patient reviews and comments when searching for an IBC-participating provider and use this information to assist in the process of selecting a physician. A comprehensive process will be in place to authenticate membership, verify a physician visit occurred within the past six months, and moderate reviews prior to them appearing on this tool. In addition, all reviews will be checked for appropriateness of language and content. Cost Estimator. This new feature will allow IBC members to review provider-specific cost range information for an assortment of inpatient and outpatient services to better enable them to estimate their out-of-pocket costs (i.e., coinsurance and deductible amounts) and manage their benefits. This information will be made available for a menu of treatment categories, which will be modified periodically. It is important to note that this cost information will be available only to IBC members who access our provider finder through our secure member website, ibxpress.com, or through MyIBXTPA.com for Independence Administrators' plan members. Hospital Quality Measures. Through the new search tool, IBC will continue to promote and encourage members to access publicly available hospital quality data, such as information published on www.phcqa.org, and other information made available via third-party data sources on IBC's websites. Additional tools that will be introduced in 2013 include: Quality Measurement & Recognition. IBC members will be able to view primary care physician quality performance measurement scores and local benchmarks. Information provided will include screening rates and other process measures, such as those included in IBC's QIPS program. Additionally, IBC members will be able to easily identify provider recognitions, such as Patient-Centered Medical Home certification, and identify top-performing practices in QIPS. Recognition icons will highlight these types of providers in the new search tool results.

Provider-facing tools

To complement the Cost Estimator feature for members, a new tool, through the NaviNet® web portal, will be introduced in January 2013 for IBC-participating primary care physicians in the Pennsylvania 5-county service area: Comparative Procedure Costs. Through a new transaction in NaviNet called Population Management Tools, IBC-participating primary care physicians in the Pennsylvania 5-county service area will be able to access the new Comparative Procedure Costs tool to view network cost ranges and provider-specific relative cost rankings for a menu of treatment categories, which will be modified periodically. These provider-specific relative cost rankings, displayed at facility level, will be based on the historical total cost of each encounter based on the contracted facility and professional costs. Look for more information regarding these new tools and features in future editions of Partners in Health UpdateSM.

NaviNet® is a registered trademark of NaviNet, Inc., an independent company.


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