Microsoft’s effort to improve the healthcare experience for its massive Eastside employee base, and ultimately lower costs, offers a template for other Eastside employers to consider, health industry officials said at the Bellevue Chamber of Commerce’s Eastside Healthcare Summit on Nov. 21.
“I think that that the other employers in the community along the 405 corridor can really benefit from … basically following in Microsoft’s wake,” and they don’t need to be Microsoft’s size, said Alex Rule, western region vice president of healthcare strategy for insurance and brokerage firm Arthur J. Gallagher & Co. He was among a handful of speakers at the breakfast event held at Overlake Golf & Country Club in Medina.
Rule said companies have an opportunity to take advantage of Microsoft’s “pick and shovel work” that went in to developing a custom health plan option, called Health Connect Plan, first offered to its Eastside employees in 2019.
Microsoft collaborated with Eastside Health Network (EHN) and Premera Blue Cross on the Accountable Care Organization (ACO) plan. EHN is a joint venture of EvergreenHealth and Overlake Medical Center & Clinics, a clinically integrated network of physicians and providers.
EHN describes itself as developing and implementing evidence-based, data-driven clinical initiatives to improve outcomes, increase efficiency, and reduce costs in the inpatient and outpatient setting.
While Health Connect Plan is exclusive to Microsoft, it offers a guidepost that other employers could follow in developing health plans with EHN, which would keep more healthcare dollars and related spending on the Eastside. EHN is working with First Choice Health, which operates in the Northwest and beyond, to administer plans companies might seek to develop.
Microsoft’s plan uses a Primary Care Physician (PCP) in the network to “quarterback” care for patients. The EHN network includes PCPs, specialists, and four hospitals, offering a focused network of care easier for patients to navigate. Financial advantages include a simple, predictable, and low-cost co-pay without restricting choice.
“You still have all the choice you want,” Sonja Kellen, senior director of global health and wellness for Microsoft, said in describing the extensive thought that went into designing the plan, which continues to be refined and improved. “There’s a different payment model if you go somewhere else, but the problem with the big system where you do anything you want is that it’s hard, then, to help you navigate your care. And that’s what we’re really striving to achieve with this plan for our employees.”
The model can save money over time, Kellen said in an interview after her presentation, “because you’re holding the system accountable, as well as us. If the total cost of care goes down, we pay incentives; (if) the total cost of care goes up, they’re held accountable for that,” she said.
EHN and First Choice Health highlighted the benefit of the more curated and personalized approach to healthcare.
“As influencers in this marketplace, we’re seeking engagement with you to help us define what the model would look like and to see how we might be able to bring better value for your dollar within healthcare benefits,” said David LaMarche, chief administrative officer of EHN.
JaJa Okigwe, president and CEO of First Choice, said such models “ultimately, should result in lower costs because it’s simpler, it’s easier, and you’re actually getting care at the right places.”