Independence Blue Cross and Blue Cross Blue Shield of Michigan have closed their transaction and finalized their arrangement to expand services to Medicaid beneficiaries nationally through the AmeriHealth Mercy Family of Cos., a Medicaid managed-care organization headquartered in Philadelphia.
“We’re excited to move forward in this progressive partnership with Blue Cross Blue Shield of Michigan to pioneer new health-care solutions in the Medicaid market nationwide,” said Daniel J. Hilferty, IBC’s president and CEO.
“Through this arrangement, AmeriHealth and its expert, experienced professionals are poised to provide industry-leading Medicaid managed care services to states, Blue plans and others and widen access to quality care in communities across America.”
Under the transaction, IBC receives majority interest in AmeriHealth Mercy, while Blue Cross Blue Shield of Michigan receives minority interest. IBC previously shared ownership of AmeriHealth Mercy with Mercy Health Plan, a subsidiary of Mercy Health System.
AmeriHealth Mercy is one of the country’s largest Medicaid companies, serving almost 800,000 members in managed care plans in three states. AmeriHealth Mercy also offers services such as pharmacy benefits management, behavioral health care and management of medical care to an additional 3.2 million Medicaid, Medicare and SCHIP (State Children’s Health Insurance Program) beneficiaries in 12 states. The company also provides expertise in customer service, information systems, claims management, enrollment and 24/7 nurse triage support.
“AmeriHealth Mercy is a highly regarded organization with an innovative approach to delivering Medicaid services on a national level,” said Daniel J. Loepp, president and chief executive officer of Blue Cross Blue Shield of Michigan.
“This strategic investment enables us to quickly gain expertise and bring that value to Medicaid consumers in Michigan.”
With the additional resources this transaction will bring from the two Blue health insurers, AmeriHealth Mercy is now better positioned to offer cost-effective, comprehensive Medicaid managed care coverage and services to Medicaid consumers nationwide and to the financially strapped state governments that provide Medicaid coverage. In 2014, the Patient Protection and Affordable Care Act expands Medicaid eligibility across the United States, and this change will increase the number of people covered by Medicaid to 16 million by 2019, according to the Kaiser Family Foundation.
The new arrangement between IBC and Blue Cross Blue Shield of Michigan provides an opportunity to Blue health plans nationwide to expand into the Medicaid market and take advantage of the growth expected in Medicaid over the next few years. The 39 independent Blue health insurance companies in the United States serve all 50 states and cover one in three Americans, but are not widely active in the Medicaid market. Two-thirds of Blue health plans do not currently serve Medicaid consumers.
To say this lady wears many hats is an understatement.
The Rev. Dr. Lorina Marshall-Blake is the president of the Independence Blue Cross Foundation and vice president of Community Affairs for Independence Blue Cross (IBC).
She is also the mother of three children: Julian, Chawnda and Jamila; and grandmother of Jamile. One can sense the feeling of pride as she notes all of her children attended an historically Black college, i.e. Howard, Lincoln, Spelman and Xavier — and are successful in their respective careers.
Marshall-Blake serves as associate minister at Vine Memorial Baptist Church and spiritual chief officer at IBC where, from time to time, she has been called on to provide spiritual support for employees experiencing personal challenges and/or when an employee dies.
Additionally, this lady serves as president of the Omega Omega Chapter of Alpha Kappa Alpha Sorority, Inc. The group is a Pan-Hellenic organization with approximately 400 members. This is a position she has held since last fall.
The chapter has initiated the Emerging Youth Leaders program focusing on leadership by design, and on purpose, through the Bailey Arrington Leadership Institute.
In her role with the IBC foundation, her philosophy is to take the social to the philanthropic. The foundation serves Philadelphia, Montgomery, Bucks, Chester and Delaware counties.
Marshall-Blake believes it important to see where the clinics are and to interact with the staff and clients. To that end, she has visited all 32 clinics. The foundation’s six-member board meets twice a year. Launched in 2011 with a $10 million budget, the foundation has awarded $3.25 million to date. She loves her job and views it as her dream job. She’s worked at IBC for 22 years and served on the board of directors at one point. Before this position, she worked at the Philadelphia Gas Works for 14 years.
Literally, a lady of many hats, she’s known for the stylish hats that she wears every day. Being ladylike is a trait she patterned after her grandmother and mother.
“It’s important for young girls to see ladies as role models and to be able to see themselves unfold and learn to have love for themselves — as referenced in Dr. Mona Lake’s poem ‘Getting Ready to Unfold,’” Marshall-Blake said.
This tastefully dressed businesswoman appreciates hearing remarks of admiration from passers-by as she moves from activity to activity in Center City.
Her wardrobe is developed from selections delivered by Fred Lee, a deacon at her church who provides this service for many of the female congregation members.
While many view her as a fashionista, she describes herself as a classic dresser. However, she always makes a special effort to seek out a unique pair of earrings from a jeweler in New York during Pennsylvania Society Weekend.
A self-proclaimed “typical” middle child of five children (one brother is deceased), she and her siblings were expected to do well, go to school and “don’t go out acting a fool.”
Her father was a master plumber and handyman, while her mother stayed home to raise the children. When she was a baby, she was nicknamed “Bootsy” because she was small enough to fit inside her father’s fishing boot.
One of her fondest childhood memories is of Friday nights eating Chinese shrimp dinner from Ms. Punchey’s.
The family didn’t vacation much, however, a visit to Atlantic City or Wildwood for the day and a trip to Ocean City for the weekend were special treats.
She reflects fondly on neighborhood entrepreneurs “Mr. Otis” and “Miss Sadie” and she feels good to still know most of the families on the street on which she was raised and where her 84-year-old mother still resides. She has a special smile as she shares that she talks with her mother every day, no matter where she is, in or out of the country, and does her laundry and performs other duties that a daughter does for her mother.
Always mindful that “God never blinks” Marshall-Blake was raised to always be grateful for whatever you have and to treat everyone with the dignity they deserve.
She attended Brooks Elementary and was in the first group of bused students (to Mitchell Elementary on Kingsessing Avenue) and Overbrook High School. She has a master of arts degree from the University of Pennsylvania, a master of divinity degree from Palmer Theological Seminary (she was ordained on July 21, 2004) and an honorary doctorate of humanities from Albright College in Reading, Pa.
Marshall-Blake sleeps only about 4 to 5 hours daily and it’s ok with her.
She’s able to balance her extremely busy business, civic and personal life because she’s organized.
She noted that she and her father, who was exceptionally organized, would be awake moving through the home and doing things while the rest of the family was still sleeping.
Mentors of this extremely busy businesswoman include Delores Brisbon, Rev. Dorothy Watson Tatum, Anne Wrice Mullin, Chris Cashman, Dan Hilferty, Bruce Crawley and Councilwoman Augusta A. Clark. She gives back by mentoring several young people within and outside of the company. The group consists of Ayana Moses, who is getting married in Ghana and has invited Marshall-Blake to participate in the ceremony), Joanne Ferguson, Shalimar Blakeley, Bridgette Daniels and Marcus Allen.
The list of role models includes her mother, first lady Michelle Obama, her pastor, the Rev. James Allen, and her good friends, the Rev. Sandra Reed and Jan Gillespie.
These three words characterize this lady executive.
Moving from meeting to meeting, and activity to event, she logs many hours on a daily basis changing from corporate hat to community member to board member to mother and friend. After knowing her for a while, many of her business associates affectionately call her “Reenie.”
The recipient of numerous awards, she is quite proud to have been acknowledged by the Wynnefield Presbyterian Church, Women of Faith, the League of Women Voters with its Civil Leadership Award, BEBASHI, the Tribune’s Most Influential list, the American Jewish Committee. She also received the G. Fred DiBona Leadership Award, the highest award given by Independence Blue Cross.
An avid reader, she enjoys material from a variety of genres and quotes from them with ease. Some of her favorite books are: the Bible; “Heaven is For Real: A Little Boys Story of His Trip to Heaven,” Todd Blupo, et al; “Great Day Every Day: Navigating Life’s Challenges with Promise and Purpose” (Max Lucado) and Dennis Kimbro’s “What Keeps Me Standing: Letters From Black Grandmothers on Peace, Hope and Inspiration.”
With respect to leadership style she refers to “Leading Like Madiba: Leadership Lessons from Nelson Mandela.” This philosophy suggests that one does not have to be in front to lead; rather, one can lead from behind using one’s influence, bench strength and by supporting others — “it’s not always about a title,” she notes.
Marshall-Blake is excited simply about life every day and the possibilities of each new day. While much of what she does is in the public realm, most wouldn’t know that she has run the IBC Broad Street Run twice (and that’s the limit she says while smiling). She also loves to cook, and is a great cook, which can be attested to by anyone who has had the pleasure of dining on a meal she has prepared.
Other community activities include serving on the boards of the Philadelphia Urban League, the Urban Affairs Coalition, the Black Women’s Health Alliance and the IBC Safety Advisory Commission. She also finds time to be affiliated with 2000 African American Women, the Community College of Philadelphia and the National Coalition of 100 Black Women.
Cultural heroes and “sheroes” include Fannie Lou Hamer, Sojourner Truth and Rev. Dr. Martin Luther King Jr. “If they hadn’t done what they did, we wouldn’t be here to do what we are doing,” Marshall-Blake said.
Living legends who complete her list include General Colin Powell, President Barack Obama, and Radio One founder Cathy Hughes.
“Our young people need to be able to see them and learn how they are able to do what they do,” she said.
Her office, with a large picture window looking out over the city, is that of a busy woman. One gets a sense of who she is and what her interests are from the books, artifacts and other materials that are displayed throughout the space.
Family photos, AKA paraphernalia, an African-American doll with a small bag of cotton (‘lest we forget’), a photo of President Barack Obama, numerous awards, a bookcase full of books and other mementos. Her degrees adorn her office walls and there is a coffee table near the cushiony couch near the entrance to her office that holds some of her favorite books.
“The key to my success is my faith walk,” Marshall-Blake said. “I believe that as I succeed, you succeed. I love my job. When I leave at the end of the day, I feel fulfilled. I am proud of what I have been able to accomplish at IBC. Those of us who are in these positions of leadership are the exception; we should be the rule, and young people should be able to see African Americans in different leadership roles.”
Independence Blue Cross has launched a $10 million foundation geared toward transforming health care in the Philadelphia region.
The IBC Foundation targets three areas: caring for the community’s most vulnerable; leading innovative approaches to health care and developing the health-care workforce of the future with an intense focus on nursing education.
“It is with great pride and enthusiasm that we announce the launch of the IBC Foundation,” said IBC president and CEO Daniel J. Hilferty.
“Building upon our deep commitment to our community, the foundation is poised to build healthier communities and spur innovation. By caring for the most vulnerable people in our community, enhancing the quality of health care for all and supporting groundbreaking innovations in health care, the foundation will help drive change in health care in our region for generations to come.”
The foundation’s creation was announced Thursday afternoon during the launch of IBC’s Nursing For Tomorrow Forum held at WHYY headquarters on Independence Mall.
Lorina Marshall Blake, IBC vice president of community affairs, will head the foundation.
The new foundation will focus on caring for the most vulnerable in the Philadelphia region by helping the uninsured get quality health care and supporting seniors and their caregivers. The newly created Blue Safety Net will provide $2 million in grants in 2011 to private nonprofit clinics that care for the uninsured and underinsured.
IBC announced foundation grants totaling $1 million to 15 clinics serving 70,000 patients in all five counties in the region.
The foundation’s second area of impact is directed at enhancing health-care delivery and will focus on developing the health-care workforce needed for the future. This work will concentrate on strengthening the region’s nursing workforce through a new $1.5 million initiative called Nurses For Tomorrow.
Nurses for Tomorrow will improve the quality of care in the region by increasing the supply of nurses and nurse educators through $1 million in scholarships awarded through 27 undergraduate nursing programs and 12 graduate nursing programs in the Philadelphia region. The Nurses for Tomorrow initiative will support the creation of three fellowships over the next two years to drive innovation in nursing education. The initiative will also establish continued education for nursing deans, nurse educators and administrators and support the development of a web-based resource for all area nursing schools.
“We are very excited about this new foundation and expanding our partnership with IBC ever further,” said Beverly Malone, CEO of the National League for Nursing, who joined IBC officials for the foundation’s launch.
“What can’t be overlooked is that IBC is not only continuing to support nursing education through scholarships, but again is leading the way in a manner no one else has thought to do.”
The foundation is launching a new Innovation Grant program that will provide $1 million to support projects and research that significantly advance the practice and delivery of health care. The foundation’s first Innovation Grant was awarded to the National Nursing Centers Consortium to enable area nonprofit clinics to use electronic medical records to provide more efficient and safer patient care.
The foundation’s website is now accepting applications for Innovation Grants at www.ibxfoundation.org.
Hilferty was joined at the foundation launch by Mayor Michael Nutter and Drexel University President John Fry, who highlighted IBC’s long partnership with Drexel.
When Sheila Green participates in the annual Greater Philadelphia Step Out to End Diabetes Walk, she’ll be thinking about members of her family.
For Green, diabetes hits close to home. Her husband, Clarence, was diagnosed with diabetes two years ago and her parents and mother-in-law also have the disease.
The impact of diabetes on her family motivated her to form a team of Independence Blue Cross employees who are members of the Blue Moonlighters Crochet Hookers Club.
“Since I don’t have it, I’ll be walking for them. I really got involved when it hit home,” Green said in regard to participating in the walk.
Green’s team has surpassed its goal of raising $1,000. The “Hooked on a Cure” team has brought in more than $1,500.
The 5K walk, which is scheduled for October 1, is the American Diabetes Association’s signature event that raises funds for diabetes research, advocacy and education. Last year, more than 3,500 people participated in the walk, raising more than $545,000.
After her husband was diagnosed with diabetes, Green was spurred to change the way she prepares food for her family. She’s cut back on cooking fried chicken. These days, her family eats more baked or grilled foods and salad.
“When it does hit home you tend to act on it. When you get it your whole life just changes all together,” Green says of diabetes.
Last year marked Green’s first time joining a Step Out walk team.
This year’s walk comes at a time when nearly 26 million children and adults in the United States have diabetes. According to the American Diabetes Association, African Americans have a more than 15 percent higher incidence of diabetes than other populations.
“It’s time to reverse this trend,” said sports legend and 2011 Step Out Walk co-chair, Billie Jean King.
“Philadelphia is a very special city to me, and I have always found this city committed to good causes like the Greater Philadelphia Step Out Walk. Diabetes is a serious disease and if we work together, we can make a difference by educating people about diabetes and committing to help those living with diabetes.”
IBC serves as the walk’s presenting sponsor.
“Our mission at IBC is to enhance the health and wellness of the people and the communities we serve,” said Daniel J. Hilferty, IBC president and CEO.
“We are steadfast in our commitment to support the Philadelphia region’s Step Out walk as the presenting sponsor for our fourth consecutive year. Our partnership with ADA and the Step Out Walk not only helps raise the community’s awareness about America’s fastest growing disease, but also demonstrates the importance of nutrition and physical activity as the cornerstones of a healthy lifestyle.”
The walk begins at 9 a.m. at the Philadelphia Museum of Art. This year’s 5K route will take walkers down West River Drive and back to the Art Museum.
The upcoming event is one of more than 140 walks held across the United States. Together, more than 100,000 participants nationwide raised more than $18.4 million in 2010 to support the ADA’s mission: to prevent and cure diabetes and to improve the lives of nearly 26 million children and adults in the United States who are affected by this disease.
For information call (610) 828-5003 ext. 4645 or visit www.diabetes.org/stepout.
Independence Blue Cross and Penn Medicine have teamed up with DreamIt Ventures to sponsor a Philadelphia-based health care accelerator – an organization that will jump start new companies developing innovative solutions in health care.
Designed to help promising health care startups rapidly accelerate the development of new products and high impact business models, the DreamIt Health accelerator will provide cash, guidance from experiencing health care executives and entrepreneur and office space to 10 young companies selected for a four-month boot camp.
DreamIt Health will accept applications now through Feb. 8 from startups nationwide in the health care sector, and on March 8 will select 10 early-stage companies that have strong founders, innovative products or services, and entrepreneurial passion to participate. From April to July 2013, the companies will work in a space at Venturef0rth in Philadelphia, whose offices are specifically designed to house and support startup companies.
The accelerator will give each selected company a stipend of up to $50,000, plus in-depth mentoring, coaching from experts, and access to other critical health care-specific resources to rapidly develop and test its product, validate its business model with potential customers, and get the company organized and ready to pitch to investors. The program will culminate in a “demo day” when the 10 companies will present their businesses to an audience of leading investors and health care organizations.
“At Independence Blue Cross, we believe that innovation is the key to bringing fresh ideas into health care and truly changing the game,” said IBC President and CEO Daniel J. Hilferty.
“From the IBX Game Changers Challenge to creating DreamIt Health, we are committed to transforming the Philadelphia region into a national magnet for health care innovation, investment, and employment.”
Officials said IBC and Penn Medicine are uniquely positioned to provide contacts, a potential customer’s perspective, and resources like access to data and technology that health care startups need to succeed.
“We are deeply committed to translating strategies from discovery to application in clinical practice,” stated University of Pennsylvania Health System CEO Ralph Muller.
“Through the partnership of Penn Medicine and IBC on DreamIt Health, we have established a collaborative relationship between the health insurer and the health system, eliminating the usual obstacles to health care innovation.”
DreamIt offers a network of mentors and a curriculum to guide the growth of young technology companies. Participants in the accelerator will have the opportunity to rapidly build out their products and services using claims and clinical data as well as other resources. By acquiring potential customer validation, participating companies will be able to accelerate their progress toward raising capital and launching to a broader marketplace. DreamIt has launched 80 companies over the past four years who have raised over $80 million in follow-on investment capital with an enterprise value of close to $330 million.
The accelerator encourages applications from companies nationwide that take a broad view of working across the health care industry, including health insurers, physicians, hospitals, and others in the health care industry, to apply technology to the challenges of proactively keeping people healthy, as well as providing more effective and affordable interventions when people get sick.
“We want to apply the same spirit of collaboration that enabled us to create this accelerator with Penn Medicine and DreamIt across the health care, technology, and innovation fields, and transform the Philadelphia region into a magnet for innovative health care technology and entrepreneurs from across the country,” stated Hilferty.
For information visit www.dreamitventures.com/programs/dreamithealth/about-dreamit-health.
Dr. Trent Haywood has been named the new chief medical officer of the Blue Cross and Blue Shield Association.
The association is a national federation of 38 independent, locally-operated Blue Cross and Blue Shield companies that provide health-care coverage for 100 million members.
“We have the ability to impact health care in every individual community in the United States, so I’m honored to be a part of this team,” said Haywood.
“My responsibility is to make certain that I can support the plans in their efforts to provide the highest quality care possible for the members in their local community.”
Haywood considers joining the Blues team as a continued evolution of his career.
“If you actually look at my career path, I’ve always been one that’s had the opportunity to be able to look at policy and the way we can implement change in policy or change in practice that can improve the quality of the care that is being provided at the bedside,” he said.
Haywood brings a wealth of medical executive experience in both the public and private sectors to his new role. He comes to his new post from VHA, Inc. in Texas, where he served as the senior vice president and chief medical officer. He previously worked at the Centers for Medicare and Medicaid Services, where he led agency priorities, including quality public reporting and value-based payments.
Haywood succeeds Dr. Allan Korn, who served as chief medical officer for more than 15 years. Korn will retire at the end of the year.
“We are delighted to welcome Dr. Haywood to the Blue Cross and Blue Shield Association,” said Scott P. Serota, association president and CEO.
“The Blues are leaders across the country in transforming health care by rewarding quality, reining in costs and improving outcomes for patients. Though we are sorry to say goodbye to Dr. Allan Korn, we wish him well in his retirement and we are certain that Dr. Haywood’s experience will help us to continue our record of innovation in communities around the country.”
Haywood holds a bachelor’s degree from the University of Notre Dame and a medical degree from the University of Illinois in Chicago. He completed his internal medicine residency at Loyola University. He also holds a law degree from Northwestern University School of Law.
He will be based out of the association’s Chicago headquarters.
Independence Blue Cross is introducing lower prices for new small business customers.
Effective December 1, IBC would begin offering new medically underwritten PPO, HMO and direct point of service Blue Solutions to small businesses that are new customers.
“The men and women who own and operate the tens of thousands of small businesses in our region face unique challenges when choosing health coverage — challenges that we understand — and we are committed to offering small businesses health plans that fit,” said Daniel J. Hilferty, IBC’s president and CEO.
“We are expanding the number of choices small businesses have for health coverage and offering highly competitive rates for new small business customers — as much as 30 percent lower than rates we previously offered.”
With the introduction of the new plans, IBC becomes the only health insurer in the region offering a medically underwritten HMO to small businesses.
In January, IBC introduced Blue Solutions, a streamlined suite of health plans that offer ways to help businesses with fewer than 50 employees control expenses.
“As a result, about half of our customers with 10 to 50 employees got premium rate reductions when they renewed their health coverage with us for 2011,” said Brett Mayfield, vice president of sales.
“When we begin to offer medically underwritten plans in December to small businesses that are new or former IBC customers, we will also be able to provide lower, more affordable rates than in the past to many more small employers.”
The new HMO health plan with medically underwritten pricing will help small businesses that want to lower costs while still satisfying their employees’ preference for Blue health plans.
Starting October 3, IBC will begin providing initial rate quotes for these new medically underwritten health plans to potential new small employer customers with two to 50 employees. Generally, businesses whose employees need fewer health care services qualify for lower rates.
“IBC’s move to medical underwriting for small group customers is a boost for many small business owners in the region,” said Jerry McGlone, president of the Greater Philadelphia Association of Health Underwriters (GPAHU), the region’s broker association.
“With the new rating methodology in place, I would expect IBC to be more aggressive in its pricing, which will result in increased competition among the major carriers and more options for small employers.”
IBC is the only insurer in the Philadelphia market that has not been medically underwriting health plans for small employers. Since competitors began offering exclusively medically underwritten coverage to small businesses in 2003, IBC has lost a significant number of customers as small employers with more healthy employees left IBC for the lower, medically underwritten rates available through other health insurers. For many small group customers who wanted a Blue health plan, there was no affordable Blue option.
“This change for small businesses can provide lower costs for many customers because it levels the playing field among all carriers, and allows the risk to be more evenly distributed across insurers, while also creating an easier transition into 2014, when health care reform takes effect,” said George Rosiak, general agent for Emerson Reid & Co. in Plymouth Meeting.
“This also creates greater opportunity for clients to benefit from their brokers’ expertise in a more competitive marketplace.”
Rosiak, who serves a large number of small business customers, added that in working with new customers, he recommends they shop the market to find the best possible fit for their businesses. With all carriers offering similar rating criteria, he would recommend customers base their buying decisions on network, carrier stability, personal demographics, and selecting a brand they trust.
Mayfield expressed how the pricing for IBC’s new small business will work.
When a small business expresses interest to its broker in a health plan from IBC, he said, the broker will provide IBC basic demographic information about the company’s employees and will request a rate quote. IBC will then provide an initial quote, based on the employees’ age and gender information and the assumption that the employees are healthy, Mayfield said.
Then the broker will ask the business’s employees to complete questionnaires about their medical histories over the past five years, he said. IBC underwriters then review the questionnaires to provide a final premium rate quote, on average, within three business days, Mayfield concluded.
“We care about all of our customers and our current small business customers will continue to get competitive rates when they renew their contracts,” Mayfield said.
He explained that beginning in January 2011, IBC changed how it set rates for its renewing small businesses and began basing rates on five factors: age, gender, location, size and claims experience.
IBC continues to use this pricing methodology for current customers, and this year, 47 percent of customers with 10 to 50 employees got rate reductions with their plan renewals, while 70 percent got new rates that were below medical cost trend, which is a measure of the increase in the costs of medical services.
Before January 2011, IBC provided pricing for new and existing small business customers based primarily on three demographic factors — the age, gender, and family status of those enrolled.
Independence Blue Cross is reporting positive financial results.
The health insurer reported an after-tax income of nearly $315 million for 2011.
After two years of incurring losses, the health insurer returned to positive financials in 2010. A second year of positive results in 2011 demonstrates the company’s financial stability and stems from investments in better serving customers, preparing for health care reform changes and enhancing the health of the people it serves.
“This is an exciting time for Independence Blue Cross and the millions of customers we serve in Southeastern Pennsylvania and throughout the country,” IBC President and CEO Daniel J. Hilferty said during a media call to highlight the company’s financial performance.
“A few years ago we experienced some financial hardships due to the weakening economy. However my predecessor, Joe Frick, began a series of moves to position IBC on a move forward-thinking path — and we’ve built on the solid groundwork that was established.”
“Despite the weakened economy, rising Medicare costs and an evolving health care environment, Independence Blue Cross successfully navigated 2011,” said Alan Krigstein, IBC executive vice president and chief financial officer.
Krigstein said IBC’s total 2011 revenue was $9.2 billion, with net income after taxes of $314.8 million and a profit margin of 3.4 percent.
“Our 3.4 percent margin is modest when compared to our publicly traded competitors whose returns were nearly double that,” he said.
In 2011, IBC paid $210.4 million in federal, state and local non-payroll taxes.
Krigstein said the company focused on three critical areas to maintain financial stability, including enhancing IBC’s core business by adding new individual insurance products and lower cost insurance for small businesses; investing in the company to modernize and become more efficient; and managing the business with fiscal discipline.
“The business decision we’ve made in 2011 are reflective of the direction that we are taking at Independence Blue Cross. Those positive results and our continued fiscal discipline will enable us to enhance our members health, remaining a committed and active civic leader in the Philadelphia region and continue to make changes that our going to transform our industry,” said Krigstein.
Over the past year, IBC attracted more than 45,000 new members by developing new lower cost health plans. Overall, IBC and its affiliated companies had 3.1 million members nationwide in 2011, a 1.4 percent increase above 2010.
Hilferty says IBC’s successful year was attributed to factors including developing lower cost health plans and forming strategic partnerships with like-minded organizations also focused on transforming the health care system.
The company partnered with Blue Cross Blue Shield Michigan to acquire AmeriHealth Mercy, forming one of the country’s largest Medicaid managed care companies. The acquisition of AmeriHealth enables IBC to expand into the growing Medicaid managed care market. The expansion of Medicaid eligibility under the Affordable Care Act is expected to increase the number of people eligible for Medicaid by 16 million by 2019.
“We’ve also allocated time, effort and funding towards adopting innovative and highly effective new patient care models to do our part in keeping our members well,” said Hilferty.
For example, IBC enhanced its nationally-recognized physicians and hospitals incentive program and opened more patient-centered medical homes which offer a team approach to high quality coordinated patient care. There are more than 200 patient-centered practices in IBC’s network serving 500,000 thousands members in Southeastern Pennsylvania.
Last year, the company launched the IBC Foundation with a total investment of $45 million. The foundation focuses on transforming health care through the communities that IBC serves. As a part of its focus on caring for the most vulnerable, the foundation supports 34 private, nonprofit clinics that provide high-quality preventive care to 145,000 uninsured and underinsured men, women and children in the five-county Philadelphia region. The foundation is also funding scholarships at 22 area nursing schools to increase the supply of qualified nurses in the region.
Headquartered in Philadelphia, IBC and its affiliates provide coverage to nearly 3.1 million people.
The Public Health Management Corporation and the Independence Blue Cross Foundation have partnered to share information about access to health care services in Philadelphia.
By combining data from the IBC Foundation related to the 34 private, nonprofit health clinics it funds throughout the region with data from PHMC’s Community Health Data Base (CHDB) Southeastern Pennsylvania Household Health Survey, the organizations will learn more about the populations the clinics serve and the savings the clinics contribute to the region’s health care system, such as reductions of approximately 20 percent in emergency room visits and of approximately 10 percent in hospitalization, among patients of Federally Qualified Health Centers versus private practices.
The analysis of this information will help PHMC and the IBC Foundation better understand where needs are not being adequately met and more effectively target gaps related to caring for clinic patients.
“In Philadelphia, 149,800 adults under 65 years, and 18,000 children, are living without any public or private health insurance coverage,” says CHDB program director Francine Axler.
“This indicates a considerable gap when it comes to accessing health care. Through our partnership with the IBC Foundation, our survey data can help identify at-risk populations and disparities so that more targeted support can be provided to those who are most vulnerable. This could translate into determining where funding goes and what specific services are provided.”
In late summer, PHMC will issue the first in a series of research briefs, drawing from the joint data, exploring access to care issues in Philadelphia and other southeastern Pennsylvania counties, as well as the outcomes that funding can help influence.
For example, PHMC’s initial assessment of the IBC Foundation’s data shows clinics funded first through the IBC Charitable Medical Care program from 2004 to 2010, and now through the IBC Foundation, have increased their capacity dramatically. According to PHMC’s assessment, the number of patients served annually across the clinics rose approximately 40 percent and the number of primary care visits provided annually by the clinics rose approximately 80 percent.
The IBC Foundation annually gathers detailed data from clinics including total patient visits, services used, insurance status, and Medicaid eligibility. In addition, the Foundation collects other useful information such as whether clinics use electronic medical records or whether the clinic may be in need of expanded services or space.
“The clinics’ overall annual operating budgets, across all sites, have shown 59 percent growth since the funding began, reflecting their ability to leverage investment from IBC Foundation to access other opportunities, most recently including major funding programs authorized by the Patient Protection and Affordable Care Act,” said Alex Lehr O’Connell, director of technical assistance and consultation for Community Health Partners for Sustainability, a program of PHMC affiliate National Nursing Centers Consortium.
“PHMC expects to explore this ability to leverage funds in greater depth in one of the upcoming briefs.”
CHDB data help to clarify the critical importance of these increases in service capacity. In Philadelphia, 16.1 percent of adults ages 18 to 64 years do not have any public or private health insurance coverage, and 12.3 percent do not have a regular source of health care to turn to when ill. Due to the large sample size of its Household Health Survey, PHMC is able to analyze its data in small geographic areas and identify trends over the more than 25 years of the survey.
“By coupling this with information from the IBC Foundation-funded clinics, we hope to gain insight into how funding helps clinics meet community needs, the impact of these clinics on health care savings, as well as information about what unmet needs require further investment,” says Lehr O’Connell.
“While the partnership focuses on the rich data from both organizations, it is the impact on individuals that drives PHMC and the IBC Foundation,” says Lorina Marshall-Blake, president of the IBC Foundation.
“We are excited about the results of this analysis and the opportunities it will bring to improve access to quality care for more people in our region.”
Through IBC Foundation’s Blue Safety Net grants, 34 private, nonprofit health clinics in Pennsylvania received more than $2 million dollars in 2011, funds that help serve uninsured Pennsylvanians.
In an effort to help change outcomes in the Philadelphia region, Independence Blue Cross has announced the “IBX Game Changers Challenge.”
Launched in partnership with Wharton Entrepreneurial Programs, the Philadelphia Department of Public Health, ?What If! Innovation Partners and Venturef0rth, the Challenge is a six-week competition seeking innovative solutions to improve the region’s health and wellness.
“We could not be more excited to announce the launch of the IBX Game Changers Challenge,” said IBX President and CEO Daniel J. Hilferty.
“By harnessing the creative energies of our community and soliciting solutions that can improve our region’s health and wellness, we are leading the way with our partners toward creating a healthier community.”
“The health of our community affects us all, and the poor status of Philadelphia’s health, as indicated in a these studies, is simply unacceptable,” said Hilferty.
“The health issues these studies highlight require fresh, creative approaches and out-of-the-box thinking; through the IBX Challenge, we want to change the game to make a difference in the health and wellness of the region.”
The challenge comes at a time when there is a need for action. A recent study published by the University of Wisconsin Population Health Institute and the Robert Wood Johnson Foundation ranked Philadelphia last of 67 Pennsylvania counties in matters related to health.
IBX seeks to serve as a catalyst for health care innovation by inviting the region’s entrepreneurs, health care professionals, college students, technology experts and others to submit high-impact ideas that can scale up to support healthy lifestyles and improve the overall health and wellness of Philadelphia and the surrounding region.
The IBX Game Changers Challenge seeks software applications, devices, products, education programs, or public awareness campaigns that can deliver a positive impact on our region’s health, with special emphasis on driving healthy behaviors such as eating right and getting fit. Entries can propose creating one-time events or campaigns or establishing ongoing for-profit or not-for-profit businesses, although preference will be given to ideas that may give rise to self-sustaining business entities.
Individuals and organizations are asked to submit their ideas through July 10 at www.ibx.com/challenge. Each proposal will be evaluated by a panel of expert judges from a variety of industries, many provided by the initiative’s sponsoring partners. Each proposal will be rated on its feasibility, scalability, sustainability and impact on health metrics. Up to three winners will be announced the week of July 30.
The winners will receive a $50,000 grant toward implantation of the proposed event, campaign or program and up to three months of office space, business support and advisory services at Venturef0rth, a health care-focused incubator in Philadelphia. Winners will also receive business mentoring from Wharton Entrepreneurial Programs and a consulting session with ?What If! Innovation Partners to help build out the idea and maximize its impact.
“The Department of Public Health is proud to partner with Independence Blue Cross on the Game Changers Challenge and its significant commitment to improving the health and wellness of the region,” said Donald F. Schwarz, health commissioner and deputy mayor for Health and Opportunity.
“Through initiatives such as Get Healthy Philly, the city is looking to increase the availability and affordability of healthy foods, decrease consumption of unhealthy foods and beverages, and increase physical activity among Philadelphians. The IBX Game Changers Challenge complements these initiatives nicely, and we are excited about its potential impact.”