Message from the Medical Director

Paul Buehrens, MD,
EHP Medical Director

From inception to recruitment in 2013, EvergreenHealth Partners had no contracts and no patients.  Starting in 2014, we signed gain-sharing contracts with EvergreenHealth for our employees and dependents, along with Cigna, and Regence (for the Accountable Health Network product) and as of January 2015, with Aetna, our largest commercial payer to date.  We have now signed with Premera for its ACO product set to launch on January 1, 2016, and as of yesterday, signed a contract through the Puget Sound High Value Network with the Health Care Authority for the public employee business.  We anticipate this contract will be used as a template for King County, L&I, Medicaid, and other lines of business from the State and County. We are serving 20,000 patients through EHP, working to generate benefits to our participants through

Path to Risk Leadership Retreat

Monique Ruyle, 
EHP Executive Director

The Evergreehealth Partner’s Path to Risk Leadership Retreat brought payer executives together with EHP physician leaders, to educate our leaders on their perspectives, and form a strategic plan in determining what actions EHP needs to take to effectively and sustainably embark on the “Path to Risk”. Risk in this context, refers to EHP contracting with payers to be accountable for the cost, quality, and access for a designated population.

Spotlight: Dermatology

In this newsletter, we’re spot lighting our Dermatology partners.  Below is a listing of our EHP member practices in Dermatology:

Pro Sports Club

Daniel Levy MD

Specialty: Dermatology 

Practice: Pro Sports Club

Johnna Millen ARNP

Specialty: Dermatology 

Practice: Pro Sports Club

Contracts Update

First Choice / EvergreenHealth Contract:  This contract covers EvergreenHealth’s employees and dependents (approx. 6,000 lives) and has been in effect since January 1, 2014.  Through benefit design, EvergreenHealth employees have been incentivized to us EHP physicians.  We are in final reconciliation of 2014 benefits costs to determine if there is a gainhare payout for EHP members.  The EHP gainsharing payout will be qualified by the level of participation in the EHP quality program.

High Value Network Signs Contract with Health Care Authority

The Puget Sound High Value Network has finalized the negotiations of a four year contract with the Washington State Health Care Authority for state employees in the Puget Sound Region, for benefit year starting 2016. The intent of the contract is to create a narrow network

Welcome EvergreenHealth Monroe

Join us in officially welcoming EvergreenHealth Monroe as a partner, working together to enrich the health and well-being of every life we touch, serving East Snohomish County. Formerly known as Valley General Hospital, EvergreenHealth Monroe became an official partner on March 1, offering care that includes Emergency Services, Outpatient Oncology, and Surgical Services. 

First Choice Contract Payout

The end of June marks the date for determining the total final shared savings that EvergreenHealth Partners are eligible for. Payout of the shared savings will follow the Fund 

Distribution Policy accordingly: 

Step 1: EHP will reimburse the physician leadership positions on the Board of Managers and

Quality Coordinator Update

Sara Rutherford, Quality Coordinator

Year one of our Cigna Collaborative Accountable Care (CAC) contract is ending on June 30, 2015 and we are vigorously working to close as many patient care gaps as possible across all of our practices.  Our latest report from Cigna, based on claims data through December 31, 2014, shows performance improvements on the following initiatives:

• Adolescent well care visits (ages 12-21)
• Avoidance of antibiotic treatment in adults with acute bronchitis
• Avoidance of antibiotic treatment in children with URIs
• Diabetic hemoglobin A1c testing
• Diabetic retinal evaluation

Care Coordinator Update

Debi Jefferson, Care Coordinator

My quality goal is to establish a more proactive and sustainable process by building process, measuring outcomes, and learning as we proceed to address each practice’s unique level of transition to Population Health.

The words “partnering” and “team effort” describe what I have witnessed over the past 10 months. This collaborative effort has helped us achieve the success we are seeing in closing gaps and improving cost savings in our first contract year with First Choice and as of June 30^th, our Cigna contract. Less than one year into the process, we have adjusted each quarter to learn how to meet the goals of our payer contracts.

Regence’s Accountable Health Networks Roadshow

EvergreenHealth Partners, along with Virginia Mason, recently held an event in EvergreenHealth’s Café 128 for over 50 brokers, looking to learn about Regence’s Accountable Health Networks called ActiveCare. 

This health insurance plan focuses on providing support for members to achieve their best health by reinforcing collaboration between providers to offer the right treatment, at the right time, and at the right facility.