Building innovative care models that work
We are positively changing the way health care is delivered by helping to build models of care that work. This includes value-based innovations and approaches to care that help improve health outcomes, break down barriers to care, and drive increased cost efficiency in the system.
Value-based care
We are leaders in developing value-based reimbursement and payment models. These are models in which health systems, hospitals, and physicians are paid based on the health outcomes we want for our members rather than on the volume of services they provide. They reward providers for delivering high-quality care, improving health outcomes and efficiency, and creating a better experience for our members. Our models include the following programs:
- Quality Incentive Payment System for primary care practices
- Total Value of Care for academic medical centers and hospitals
- Episodes of Care for specialists, academic medical centers, and hospitals
- Mental Health for inpatient facilities and outpatient professional providers
- Nephrology Pay for Value program for nephrology practices
As of 2025, 90% of eligible health systems in the Philadelphia five-county region are engaged in IBX’s Total Value of Care program.
Clinical Care Innovation Program
Our Clinical Care Innovation Program is transforming the way health care is delivered by helping to design, test, and scale improved models of care. It gives providers in the IBX network a rapid, safe, and structured way to receive funding and test new care models that can improve health care delivery, quality outcomes, and affordability for our members and the community at large.
The program utilizes a two-armed approach with grants and pilots to support new and innovative care delivery ideas, cutting-edge models of care, and mature initiatives.
New and innovative care delivery ideas need support to better assess efficacy and efficiency and refine their approach. Our Clinical Care Innovation Grants support these novel approaches. They foster new, innovative approaches to care delivery that are ultimately intended to help improve the health and well-being of IBX members and the community at large. As of 2023, we supported 22 projects from six regional health systems or large specialty groups in our network, with an aggregate of $4.3M in investments from IBX. The grants focus on a range of topics, such as maternal health, chronic kidney disease, remote cardiac rehabilitation, palliative care, and more.
Cutting-edge models of care have been investigated and demonstrated success outside of our market and in investigational settings but require further collaborative development with our provider partners to optimize their value for our members. These pilots focus on clinical priorities like remote patient monitoring/telemonitoring, moving care closer to home, behavioral health, health equity, and more.
Mature initiatives are models of care that have been proven with our network providers and are being scaled more broadly across the IBX network. Initiatives like our expansion of the Collaborative Care Management Program, which integrates mental health professionals into the primary care setting, fit in this category.
Together with the providers in our network, IBX is seeing strong results from the Clinical Care Innovation Program. Research shows that it typically takes 17 years to implement a change in care patterns. However, IBX has seen a 50% success rate in scaling work supported by this program.
Learn more
IBX news and commentary about building innovative care models: