While the Tandigm model is similar to a traditional health-management organization in that IBC will spend a fixed amount for each insured person, Tandigm will not use physicians as gatekeepers, but rather as care managers.
"Given the right tools, the right incentives, and the right resources, physicians become the nucleus of the managed-care enterprise," said Anthony Coletta, Tandigm's president and chief executive.
Coletta said Tandigm's goal was to attract enough doctors to have a pool of at least 50,000 patients when it launches Jan. 1. It already has reached 71,000.
Financially, Tandigm and its physicians will be motivated to keep people out of hospitals, because that's where the most expensive care happens.
Davita, a publicly traded company based in Denver, already cares for 830,000 patients under similar arrangements in other parts of the country. In May, Davita said it expected to have $10 million in start-up losses on Tandigm, which only operates in the Philadelphia region, and did not expect quick profits.
The bulk of the doctors with Tandigm contracts came from the Renaissance Health Network, a large physicians group based in Wayne.
Renaissance accounts for 240 of the doctors in Tandigm. Only two Renaissance doctors opted out, said Barry Green, who practices family medicine in Lansdale and is chairman of Renaissance.
Renaissance managed patients "to a higher level of care, which ultimately was found to reduce costs, keep them out of the hospital, keep people out of requiring complicated specialty care, and so this becomes the next iteration of that," Green said.
Renaissance also contributed its chief medical officer, Kenneth Goldblum, to Tandigm.
Thomas Lyon, who is one of six providers at Mount Airy Family Practice, said his group joined Tandigm because it seemed like a natural fit for a new approach his group is adopting.
In traditional medical care, the focus has been on the patient in the doctor's office, Lyon said.
"That remains the case, but nowadays there's been a shift. We're also thinking about patients who aren't coming to see us," Lyon said. "This is still my patient, but they haven't been in. How do we make sure that their care is as good as the patient who's right in front of me?"
Among the strategies used by Lyon and his colleagues are pushes to increase preventive-care screening rates and achieving certain goals for chronically ill patients as a population, not just on a case-by-case basis.
"It's not just to reduce hospital stays; it's to give better care," Lyon said.
"Patients don't want to be in the hospital, and we don't want them in the hospital."