Group Health Cooperative says it will begin offering a preferred-provider health plan to employers in Spokane County this summer.
The plan, called a PPO, or preferred-provider organization, will be a new option here from Group Health, which has operated a health-maintenance organization, more recently called a managed-care plan, for decades.
It will be sold to employers who have their headquarters in Spokane County and have more than 50 employees, says Lloyd Guthrie, Group Healths district administrator. Its actually a statewide product, but its only being offered in Spokane County right now.
Dr. Brad Pope, Group Healths longtime medical director here, says, The market is expecting more choice right now.
Separately, Guthrie says Group Health opened last fall at its administrative offices at 5615 W. Sunset Highway a new customer-service call center, where members and contract health-care providers can telephone for answers to their questions. Counting those 30 people, Group Health now has 810 full-time-equivalent employees in its Eastern Washington-North Idaho district, which includes Spokane and Kootenai counties, Guthrie says. He says its possible the cooperative will add another facility of some kind here, although it currently doesnt have concrete plans to do so.
This area offers a very competent work force, Guthrie says. The cost of operation here is modest compared with Seattle. The company recognizes that.
Guthrie adds, Those of us who manage the business in the eastern part of the state are active advocates for our economy in the eastern part of the state.
The launch of a new PPO here is part of a statewide strategy Group Health has to grow, Guthrie says. In King County, he says, Group Health is building a $140 million specialty care and outpatient-care center adjacent to East Overlake Hospital, and its taking other steps on the West Side to help it grow.
The organization has about 80,000 members in Spokane County, and it hopes that the PPO will help it to add to that number, Guthrie says. Group Healths membership here has been relatively flat over the last five to seven years, which has pretty much been in keeping with the insured market here, he says.
Group Healths managed-care plan, which requires members to obtain referrals from primary care physicians before receiving care from specialists, has contracts for service with 65 percent of the physicians and other health-care providers in Spokane County. As the cooperative has worked to launch its new PPO, it has sought contracts from additional providers over the past year, and it now has contracts with almost 90 percent of all providers in the county, Guthrie says.
A greatly increased number of relationships with providers definitely adds to choice, particularly for members under the age of 35, who have less contact with health-care providers than older patients and tend to focus more on convenience, Guthrie says.
Yet, choice comes in many forms, and in addition to giving employers a new health plan to offer their employees, therell be a mix of co-pays (and) deductibles that will give employers different ways to divide their share of the cost of health care and their employees share, Guthrie says.
Employers will have a greater range of choices in terms of (insurance) premium sharing with their employees and cost sharing with their employees, he says. Sharing financial responsibility for health care (between employer and employee) is increasingly important.
Group Health operates four clinics in Spokane County for members, at 322 W. North River Drive, near downtown; at 6002 N. Lidgerwood, on the North Side; at 3104 S. Regal, on the South Hill; and at 14402 E. Sprague, in Spokane Valley. Members obtain hospital care here at Sacred Heart Medical Center, Holy Family Hospital, Valley Hospital & Medical Center, and Deer Park Hospital.
Kootenai County residents who work for Spokane County employers and enroll for service under Group Healths PPO will be able to obtain care at Group Healths Coeur dAlene clinic, at 2010 N. Lakewood Drive, and obtain hospital care at Kootenai Medical Center there.
Group Health will begin promoting the PPO plan at the end of this month, Guthrie says. Most of our efforts will be directed at brokers. Of course, they have direct interface with employers.
Group Health doesnt plan to offer the PPO to Idaho employers, Guthrie says. That could only be done if it made an additional filing with regulators in Idaho, he says.
The PPO will be sold through Group Health Options Inc., a wholly owned subsidiary of Group Health Cooperative. Group Health Options is licensed with the state as a health-care contractor, while Group Health Cooperative is a licensed HMO.
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