First Choice / EvergreenHealth Contract: this contract covers EvergreenHealth’s employees and dependents (approx. 6,600 lives) and has been in effect since January 1. EHP providers are now covered at the same benefit level as EvergreenHealth employed providers.
Cigna Contract: the Cigna contract went live July 1. EHP is one of three network options (along with The Polyclinic and Northwest Physician Network out of Tacoma). About 3,400 lives have been attributed to EHP. This is a gainsharing contract that rewards cost savings and improvments in quality. In addition, Cigna is giving us $1.50 per member per month to help with our care management work. Part of that money will help pay for the nurse care coordinator.
Regence Contract: we’d hoped for approval of a July 1 start
date, but this contract is stuck in the approval process at the Office of the
Insurance Commissioner and a decision likely won’t come until fall. 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 members to see EHP providers. Those
who sign up for this plan will have to select one of the four systems for their
care. Because of our fine clinical results, the EvergreenHealth Partners system
is one of the lower priced options…so it should be an attractive choice. This contract is a gainsharing arrangement with
a case management allowance.
High Value Network We are in discussions to create the Puget Sound
High Value Network that would include EHP, Overlake, Everett Clinic,
Franciscans, Virginia Mason, Puget Sound Family Practice and Lakeshore. First Choice
will offer the Puget Sound High Value Network to self insured employers
as a lower price alternative. The
product uses benefit design to steer insured members to the systems that are in
Network. First Choice contracts that are
in place for EHP members will apply to this new network. The Board of Managers will be considering
this for approval.