Regence BlueShield of Idaho has entered into an agreement with St. Luke's Health System, using a model that Regence's parent company has used in Washington state.
The health insurer and hospital system will coordinate care for patients who have multiple health problems under the program, called the Healthy U CoPartner Program. Doctors and nurses in the St. Luke's system will work closely with Regence patients to make treatment plans, lifestyle changes and other adjustments to improve overall health. The program aims to cut costs and duplication in health care for those patients.
Regence members who meet certain criteria and agree to enroll in the program will be assigned to a nurse care coordinator who is part of a health care team. That team works with the patient's doctor to coordinate care with specialists and in different health care settings. Regence members enrolled in the program will also have their copayment or coinsurance waived for the first visit with the team and will be encouraged to stick with the program to make sure their progress is tracked over time.
"Studies have shown that 5 percent of the population with the most complex and extensive medical conditions account for almost half of health care spending in the U.S.," said Scott Kreiling, president of Regence BlueShield of Idaho.
One of the pilot programs used by Regence BlueShield of Idaho's affiliate in Washington cut per-capita spending by 20 percent, improved physical and mental functioning by almost 15 percent and added 18 percent more access to health care, according to Regence.
"It is through efforts like these that we can truly improve the health of the people in Idaho. ... We need innovative solutions and we need physicians, hospitals, and insurance companies working together with patients to be successful," said David Pate, president and chief executive officer for St. Luke's Health System.
Blue Cross of Idaho in May announced a similar partnership with Saint Alphonsus Health System a new brand of family and individual health insurance, under which patients would see Saint Alphonsus-affiliated doctors and specialists.
People covered by those plans would see a primary care doctor in the Saint Alphonsus network. That doctor refers the patient to specialists and provides routine and preventive-care services. Blue Cross said that by coordinating the patient's care, the doctor could monitor it and decrease repetition.