THE HERALD BUSINESS JOURNAL    EVERETT, WASHINGTON

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Jim Davis, Editor
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Published: Friday, April 19, 2013

Providence-Swedish massage health insurance

EVERETT — A new way for businesses to provide health care for employees is being developed by Providence Health & Services and Swedish Health Services.

The Providence and Swedish affiliation is working toward an accountable care network to begin in early 2014 for self-insured companies and individuals. The new program will focus on keeping people healthy and helping them manage chronic conditions and diseases.

The cost of health care is just too expensive and that needs to change, said Preston Simmons, chief executive officer of Providence Western Washington Region Northwest. Simmons oversees the operations of Providence Regional Medical Center Everett and serves on the executive team that supervises the affiliation.

“The country economically is changing, health-care reimbursement is declining and the state has less to spend on health care,” he said. “Our vision really is around creating healthier communities and having it cost less.”

Providence Health & Services and Swedish Health Services joined together in February 2012 to improve health care quality, access and affordability for people in Western Washington. In its second year, the affiliation’s leaders are spending significant time listening to customers to understand how to meet their needs, Simmons said. One takeaway so far in this process is the request that health care is available close to home.

“As part of an accountable-care organization, we are making sure we’re investing in primary care. That’s really the wave of the future,” Simmons said. “Right now we have about 50 separate practice sites just for primary care throughout the local counties we serve and we’re continuing to invest in local practice.”

Through the accountable-care network, patients would receive increased access to their primary-care provider and support from a nurse-care manager. Patients would also have access to medical specialists through Providence, Swedish and affiliated physician partners. In addition, the affiliation offers a range of ambulatory care centers, home-care services, skilled nursing facilities and other non-hospital care settings.

Under current care models, a diabetic patient may receive nutritional advice and counseling from their primary-care provider. That method is passive to some extent, said Lawrence Schecter, chief medical officer for the affiliation’s Western Washington region.

“In a future model, (the patient) will get a phone call from a nurse talking to them about their condition, their medication, their circumstances and their needs, and hooking them up with a nutritionist to go over their diet,” he said. “The primary-care physician has a team of individuals all working together.”

The affiliation is working hard to create the framework of the network, Schecter said. This year it’s focused on developing a physician-led structure to allow clinicians to drive best practices and is exploring partnerships with other physician groups to ensure employers have access to a variety of providers in convenient locations. The affiliation will also assemble resources such as information technology systems, analytics and care management services to review claims data, provide performance reports cards to participating clinicians and manage the health of patients.