“The Puget Sound High Value Network … gives employers the value they seek – high quality, cost-effective care at a reduced unit cost to businesses.”
- Gary S. Kaplan, MD
There are countless lessons from the Virginia Mason experience during the past dozen or so years, but the lesson that transcends all is always putting the patient first. When the patient is always the center of attention, the quality of care, access, and affordability all improve.
The patient-first mantra extends well beyond the exam room and the hospital all the way to decisions about selecting partner organizations with whom to affiliate. That is why the creation of the Puget Sound High Value Network is one of the most important breakthroughs in the Washington marketplace. Virginia Mason is a founding member of this new network that includes a highly select group of provider organizations that have made the cultural leap forward to put patients first in all things at all times.
This patient-focused approach is very different from organizations where the major driver is market dominance and the bottom line.
“The Puget Sound High Value Network is game-changing,” says Virginia Mason Chairman and CEO Gary S. Kaplan, MD. “The network gives employers the value they seek – high quality, cost-effective care at a reduced unit cost to businesses.”
Every member of the network has significantly reduced contract rates with First Choice Health, thus providing the value that companies are seeking in this challenging new health care environment.
Dr. Kaplan says that a fundamental question “is not ‘how big do we need to be?’ but ‘how good can we be?’” For patients and their families there is a profoundly important shift from simply accumulating or rewarding scale to aligning philosophies and operating with shared systems, values and priorities.
“The Puget Sound High Value Network is an example of how to enable geographic coverage and a full breadth of services by knitting together a group of like-minded providers, gaining the advantages of scale without the concentration of providers that, in the end, has proved so detrimental in other markets.”
While the health care marketplace is experiencing turbulent times, it becomes increasingly clear each day that the future is about value; value defined as the highest quality care at the lowest cost. That is what employers want and that is precisely what the new network is designed to deliver.
One way to define value is the Triple Aim, a construct of the Institute for Healthcare Improvement, defined as:
- High quality individual care
- High quality care for populations of patients
- Reducing costs
This definition of value is the Holy Grail for the Puget Sound High Value Network.
During a recent broker symposium in which the network was officially announced, Curtis Taylor, chief marketing officer, First Choice Health, which administers the program, said, “The Puget Sound High Value Network collaborative is a group of unaffiliated industry-leading hospital and medical group professionals forging a ground-breaking relationship to serve community employers and their employees. This is an ACO (Accountable Care Organization) for employers.”
“The future is now!” added Jonathan Hensley, President, Capital Benefit Services. “With the market deployment of the Puget Sound High Value Network, the future is now defined by providers and health care organizations that deliver sustainable value, which I define as quality care plus superior patient experience plus lower total cost of care.”
During the past couple of years, both Virginia Mason and EvergreenHealth have implemented the Puget Sound High Value Network approach with their employees. Says Hensley, “While the data is too immature to declare absolute success, the early results for EvergreenHealth and Virginia Mason’s employee benefits program are incredibly promising. They’re setting the example that I expect many employers to follow.”
Puget Sound High Value Network
Joining Virginia Mason in the new network are EvergreenHealth, Franciscan Health System, Lakeshore Clinic, Overlake Medical Center, Edmonds Family Medicine and The Everett Clinic. All participants are aligned philosophically and share a commitment to collaborate on ongoing clinical initiatives focused on delivering quality, efficiency, value and coordinated care to patients.
The scope of the network’s footprint supports employers by reducing their health care costs while enhancing the health and well-being of employees and their families where they live and where they work.
The network stretches from Tacoma to Everett, across eight hospitals, 164 clinics, 23 ancillary provider locations, and through 2,835 specialty and primary care providers.
Why are health care organizations turning to networks like this?
In response to changes in the nation’s health care system, providers and organizations are aligning to develop ongoing clinical initiatives focused on delivering quality, efficiency, value and coordinated care. In these models, participating health care organizations and providers manage care across specialties and develop contracts with payers to improve quality while controlling costs.
How is PSHVN different from other health care networks or benefits plans?
Participating providers and health care organizations are selected for demonstrated commitment to quality, and offer cost savings to employers between 10 to 13 percent over competing options.
Who benefits from this network?
Employers benefit from increased access to a comprehensive network of care providers at a reduced cost, and participating providers can better coordinate patient care with a broad network of specialists who share a commitment to quality. PSHVN providers are selected for demonstrated quality outcomes and a commitment to reducing costs, and for providing patients access to the participating providers’ hallmark high-quality, patient-centered care, but at a lower cost.
How does PSHVN achieve cost savings?
Network members are committed to achieving lower costs through more seamless coordination of care, and are able to achieve other economies by working together to manage care.
Will employees and their dependents have to travel a greater distance to see specialists in the PSHVN network?
No. The network reaches from Olympia to Everett and includes more than eight hospitals, 163 clinics, 24 ancillary providers and 2,875 specialty and primary care providers, so employees in the Puget Sound region will find participating providers near where they live and work.
What providers are included in the PSHVN network?
Participating organizations include CHI Franciscan Health, Edmonds Family Medicine, The Everett Clinic, EvergreenHealth Partners, Lakeshore Clinic, Overlake Medical Center and Virginia Mason.
Who oversees PSHVN?
First Choice Health is the network administrator and offers benefit administration and support for employers and employees through customer service, online member and employer portals and more.
What organizations can offer PSHVN to employees?
PSHVN is available to self-insured organizations with 50 or more employees through First Choice Health, the plan administrator.
Can coverage be customized?
First Choice Health will work with larger self-insured organizations to customize network offerings. For smaller groups, First Choice Health offers a comprehensive standard offering that connects employers and employees to PSHVN.