Monday, May 19, 2014

Contracting Update

First Choice / EvergreenHealth Contract:  this contract covers EvergreenHealth's employees and dependents (5,500 lives). EvergreenHealth's coverage plan has been expanded so EHP providers are now covered at the same level as EvergreenHealth-employed providers, increasing employee options from 180 to 446 providers.

Regence Contract:  this contact is going to the Office of the Insurance Commissioner for approval, with a target July 1 start date. EHP will become one of the four systems in Regence's new Accountable Health Network (along with The Everett Clinic, Multicare and the UW), which would provide significant incentive for Regence-insured employees to see EHP providers. This is a new product. It will be a gain-sharing contact; clinics will continue with your fee-for-service contracts.


Cigna Contract: we just signed a contract with Cigna, with a July start date.  We were able to get a waiver so our primary care practices won't need the medical home certification that was initially required. This would also be a gain-sharing contract, and you would continue with your fee-for-service contracts.

Other Contracts:  we're continuing to talk with Premera and several other payers, and also discussing possible EHP participation in Medicare Advantage in the future.

We've hired consultant Jonathan Hensley, a former CEO at Regence, to help us package EHP for marketing to self-insured employers.