Health, Assured

PacificSource Health Plans and Legacy Health partner on an innovative and integrated model of care.

Share this article!

Healthier populations, better patient experiences, and quality care delivered at a cost that won’t break the bank.

It’s a vision for regional health as appealing to Northwest providers and insurers as it is to the consumers they serve, says PacificSource Health Plans CEO Ken Provencher. But achieving it will require a collective commitment to working collaboratively and not just independently.

“We’re in a period of tremendous change and disruption in the whole healthcare environment,” Provencher notes. “We came to believe that if we could find the right partner to move to that next level of alignment and create an integrated approach, that would be the better way to go.”

Leap, as they say, and the net will appear. For this community health plan, that net has materialized in the form of a nascent provider-payer partnership with Portland-based Legacy Health.

Under its terms, Legacy will purchase a 50% member interest in PacificSource, and PacificSource will gain closer ties to a top-tier hospital system.

Integrated delivery of care leads to better-coordinated, more affordable services, which empowers organizations to bridge difficult gaps in the current healthcare system — an appealing premise for Legacy Health CEO George Brown, M.D.: “We are committed to serving our populations well, and considering the current circumstances we’re facing, we have to demonstrate we’re improving the health of people we serve, and do that in a way that costs less and helps patients have a better experience.”

Together, these two mission-driven, not-for-profit organizations hope to demonstrate the transformative power of this approach to regional healthcare, says Provencher. “Our model really creates a level of alignment that goes beyond traditional relationships. It’s not just a contract. We’re really together forever, and our motivations and incentives are the same.”

Key among those motivations: to smartly steer their respective organizations through an uncertain healthcare future. The expansion of Medicaid and the establishment of the Affordable Care Act have granted Americans unprecedented healthcare access, Brown notes. That’s good, but it also presents significant logistical challenges. Meanwhile, the price points for crucial medical and pharmaceutical technologies are soaring.

America’s healthcare system simply must do better, says Brown: “Despite spending the most on healthcare per capita of any nation on earth, we don’t enjoy the best health, and it’s not getting better. What Legacy and PacificSource have done is to create a partnership aligned behind the same agenda to look at these issues and try to work together to solve them.”

It’s a model that’s already catching on, adds Provencher: “If you look across the country, you’ll see more and more of these partnerships being formed. And most are occurring on a regional basis.”

The burgeoning partnership between PacificSource and Legacy Health is not exclusive — PacificSource will continue to build relationships with health systems across Oregon, Idaho and Montana while Legacy will continue collaborating with other insurers — but both men hope it will be an enduring one, capable of fostering healthier communities for years to come.

“When you’re able to manage a population’s health needs, project out those needs over time, and enlighten providers as to what’s coming down the road, you decrease costs and also, over time you increase the health of that population,” says Brown.