REGIONAL— A new small business health care insurance option will soon be available in northeastern Minnesota, offering a tight-knit network of regional health care providers and, potentially, lower …
REGIONAL— A new small business health care insurance option will soon be available in northeastern Minnesota, offering a tight-knit network of regional health care providers and, potentially, lower cost premiums.
The locally-developed plan, known as Wilderness Health ACO, offers northern Minnesota employers more choice in how they provide employees health care coverage, according to Cassandra Beardsley, executive director of the nonprofit entity that has developed the health care alternative. Beardsley notes that most workers in the Arrowhead are employed by small companies, which have often not had quality, affordable health insurance options in the past.
ACO stands for Accountable Care Organization, which is a system under which various providers agree to work closely together to coordinate care for individual patients. ACOs are designed both to improve care and increase medical efficiency, thereby helping to control costs.
The plan features 10 regional hospitals, including St. Luke’s, Fairview Range, North Shore Health and the Cook Hospital and more than 30 primary care clinics, including Scenic Rivers. On average, the ACO plan is 15 percent less expensive than open access network products, although employees can choose an open access option, which comes with a higher premium. Currently, the Essentia and St. Mary’s system is not part of the Wilderness Health network.
The nonprofit board that oversees Wilderness Health, founded in 2013, is comprised of member hospitals, according to Beardsley, which came together to help devise the locally-based health option. Working out the details for the ACO took time, said Beardsley, about two years from the time the board opted to move forward.
Wilderness Health is working with PreferredOne, a Golden Valley-based flexible health plan administrator, which is the contact for employers interested in exploring coverage through the new system. Wilderness Health is currently enrolling large employers, but will start working with small businesses later this summer, in time for them to enroll for coverage beginning in 2018.
The new Wilderness Health ACO is expected to offer better coordinated care to patients. “ACOs are PreferredOne’s fastest growing care model in Minnesota,” says Fride Mauritzen, Senior Small Group Sales Representative for PreferredOne. “The plan coordinates member care to manage chronic conditions and minimize inappropriate or excessive procedures. We have data to prove how effectively the model reduces costs and improves healthcare quality.”
Beardsley notes that the new health option should also benefit health care providers in rural communities in the Arrowhead by keeping local patients close to home and keeping their health care dollars in the community. “There’s value in keeping health care local. To do that well, we need a sustainable model that aims to lower costs and increase quality of care,” said Beardsley. “Wilderness Health ACO delivers dozens of plan designs at a fair price for fully insured and self-insured employers.”
Employees can choose the ACO network and see immediate savings on their premiums. They can visit any provider within the Wilderness network. Employees can also choose an open access option for statewide coverage since most employers offer the plan options side-by-side. In either case, said Beardsley, “The networks include Minnesota’s best-regarded specialty physicians for complex or critical care.” Employers also have the choice to add a travel network or coast-to-coast coverage—an advantage for families with students who attend out-of-state colleges.