About 40% of Physicians Health Plan of Northern Indiana (PHP) members don’t have a primary care physician. The health plan aims to change that through a new partnership.
PHP announced last week that it is working with Premise Health, a national provider of digital and in-person primary care, to open a pilot primary care center in Fort Wayne, Indiana. The center, scheduled to launch in late summer, will be exclusive to members who are employed by PHP’s fully-insured employer clients in Allen County, Indiana.
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“We want to get more of our members engaged with a primary care physician, which will help member’s address health issues as they emerge rather than letting them progress into larger health issues in the future,” said Gary Shearer, PHP president and CEO, in an email. “This clinic will help our members get ahead of emerging health issues so they can make lifestyle changes that will positively impact their future health.”
Members will gain access to a care team comprising physicians, nurse practitioners, a behavioral health specialist and medical assistants. That will help members not only receive services for primary care, but also behavioral health, chronic condition management, biometric screenings, referral management, women’s health and provider-dispensed medications. If members require specialty care, Premise can refer them to providers within PHP’s network.
While the pilot program is starting with the center in Fort Wayne and only with fully-insured members, PHP will look to expand into other locations and other product segments (including self-insured) if the program is successful, Shearer said.
“The best way for us to get started was to target a finite group of fully-insured members, in a specific geographic market, and in specific product segments,” he said.
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PHP is paying Premise a per member per month fee for the clinic. The partnership will aim to improve primary care engagement with longer visits and improved health outcomes, said Stu Clark, CEO of Premise.
“Providers, physicians, nurses, pharmacists, behavioral health specialists didn’t go to school to be billing machines,” Clark said in an interview. “A lot of times the fee-for-service model puts such an administrative burden on these people that they actually can’t practice as much care as they want to. In our model, we mandate our providers to get that patient engaged with their own health and spend as much time with them as [they] need and have the conversations with them that are really meaningful around their long-term health.”
Premise’s mission to engage patients and allow providers to spend more time with them is what led PHP to choose the company as its partner, Shearer said.
“Premise’s operating model is different from standard primary care and urgent care clinics, as patient visits are longer and focused on building a relationship with the patient to build mutual respect and trust between physician and patient,” Shearer stated.
Photo: mikdam, Getty Images
