The Boeing aerospace and aircraft company has signed on as the first large group health insurance client of the accountable care organization formed by Renton, Wash.-based Providence Health & Services and its affiliate, Seattle-based Swedish Health Services.
Under the agreement between Boeing and the Providence-Swedish Health Alliance, about 27,000 employees and 3,000 retirees of Boeing in the Puget Sound region of Washington state will be eligible to select the Providence-Swedish Health Alliance ACO as their health network.
The Providence-Swedish Health Alliance ACO will use a population health approach and a value-based reimbursement model — rather than a fee-for-service model — to improve care delivery and patient outcomes and to lower costs, according to information from the Providence-Swedish Health Alliance ACO.
Providence Health & Services and Swedish Health Services affiliated in early 2012 and have since been developing the Providence-Swedish Health Alliance ACO as the vehicle for their accountable care organization projects. They have been doing so by aligning their approximately 50 western Washington primary care clinics and independent medical group practices so that they can better coordinate care, share best practices and adhere to the ACO's reimbursement model, which pays clinicians based on the value delivered, as measured by metrics. Quality metrics for participating clinicians — some of whom are employed by Providence-Swedish and some of whom are contracted — have to do with clinical outcomes, health status, preventive measures and patient satisfaction, according to information from the ACO.
The ACO will improve care and lower costs, its leaders said, by better coordinating care for patients and helping patients to improve their health. For instance, the ACO will offer same-day or next-day appointments for urgent primary care visits and acute care; a concierge service that assists patients by phone, email or the Internet; online and mobile means of scheduling appointments and reviewing test results; support with decisions about accessing care; and support for chronic disease management. Much of this support will come from a care team that will remind patients of appointments, advise patients as they weigh treatment options and recommend healthy lifestyle changes. These care teams will be made up of nurse case managers, behavioral health specialists, pharmacists and others.
ACO leaders said they are facilitating this model by working with physician leaders in each of the ACO's medical groups to use patient data to identify opportunities to improve care and outcomes. The ACO also is providing incentives for clinicians to promote better outcomes and providing them with better access to data and increased support from the care teams.
Boeing employees who choose to participate in the benefit plan of the Providence-Swedish Health Alliance ACO will pay higher deductibles and co-pays if they seek treatment from a provider outside of the ACO's network.
During the November open enrollment period for coverage beginning in January, the eligible Boeing employees will choose between their current health plans, the Providence-Swedish Health Alliance ACO and the UW Medicine Accountable Care Network. Vancouver, Wash.-based PeaceHealth is part of the UW network. Chicago-based Boeing is self-insured; BlueCross BlueShield of Illinois is Boeing's plan administrator.
The Providence-Swedish Health Alliance ACO also serves patients insured by government payers, under a separate network. Providence-Swedish became an official Medicare ACO in December 2013 under the name Health Connect Partners. It is one of three Medicare ACOs in Washington.