Eastern Oregon hospitals are partnering to launch a new health insurance option.
The newly formed Summit Health will offer Medicare plans to residents of Umatilla, Morrow, Baker, Gilliam, Grant, Harney, Lake, Malheur, Sherman, Union, Wallowa and Wheeler counties. The plans will be available when open enrollment for Medicare begins on Oct. 15.
Harry Geller, CEO of CHI St. Anthony Hospital in Pendleton, said the hospitals involved have already had a unique and “very successful” partnership with each other and Moda Health in improving outcomes for Medicaid patients through the Eastern Oregon Coordinated Care Organization.
“That mutual respect and collaboration is a fundamental reason it has been so successful,” he said. “It’s a very refreshing working relationship.”
Those same founders of Summit Health are St. Anthony, Good Shepherd Health Care System, Grande Ronde Hospital and Clinics, Saint Alphonsus Health System, GOBHI, Eastern Oregon IPA, Yakima Valley Farm Workers Clinic and Moda.
Geller said right now in Eastern Oregon there aren’t many senior citizens participating in Medicare Advantage plans, and Summit Health will be able to offer them more choices. He said the providers were excited and optimistic about the benefits to residents.
“There’s a big gap in the market for this sort of plan,” he said.
Medicare Advantage is an all-in-one type of Medicare plan offered by private health insurance companies under a contract with Medicare. Those plans bundle parts A, B and D of Medicare coverage together and sometimes offer additional benefits, such as dental or vision that traditional Medicare doesn’t cover.
Dennis Burke, CEO of Good Shepherd Health Care System in Hermiston, said offering Medicare Advantage plans through Summit Health will offer area senior citizens more options, but it also gives greater flexibility to the hospitals involved.
By receiving a flat, contracted rate from Medicare instead of per-procedure reimbursement, Burke said they can use the money more creatively for preventative care and measures that can help improve outcomes for patients before they need an expensive treatment.
One example he gave was the hospital’s CareVan program, which gives patients free rides to appointments to ensure they don’t end up canceling a doctor’s appointment or not seeking treatment in the first place because they don’t have a ride. A missed appointment can mean a missed opportunity to catch a problem early, resulting in more expensive treatment later.
Coordinated care organizations, such as Eastern Oregon Coordinated Care Organization, were founded on a similar idea of reducing health care costs through preventative care and overcoming barriers to care, such as limited transportation. Those organizations focus on Medicaid patients, such as those on the Oregon Health Plan, but Burke said the EOCCO partners have learned a lot from that partnership that can be applied to the population using Medicare.
“I think we’ve gained quite a lot of experience doing that,” he said.
Sean Jessup, the president of Summit Health, said the insurance group is a partnership of local providers with a track record of working successfully together, that patients already know and trust. He said there has been “limited options” for for Medicare Advantage in Eastern Oregon in the past.
“This product is for Eastern Oregon, and operated by Eastern Oregon providers,” he said.
Open enrollment for Medicare begins Oct. 15 and ends Dec. 7, 2020. Medicare enrollees can visit yoursummithealth.com or talk to their local insurance agent about plans offered by Summit Health.