Editor’s note: This is the first installment of an exclusive two-part series that explores the changing relationship between primary care and insurance plans. In part 2, FierceHealthPayer talks to COO Mike Koziara about Priority Health's Comprehensive Primary Care Plus initiative.
As the healthcare industry embraces value-based care, insurers have learned that it sometimes takes a village to improve the health of populations--often driving them to reach across the aisle to providers.
Increasingly, that means not only partnering with major hospitals and health systems, but also turning to the place where most consumers’ healthcare experiences begin--primary care.
A notable example is UnitedHealth subsidiary Harken Health, which operates clinics and sells insurance plans to individuals and small businesses in Atlanta and Chicago. The company recently pulled out of the ACA exchanges in South Florida, but will continue to focus on its core markets in Illinois and Georgia.
“We started from the beginning to develop a new experience for people that we thought people might love,” Krista Nelson, co-founder and vice president of strategy for Harken, tells FierceHealthPayer in an exclusive interview. “And it started with primary care.”
Nelson’s desire to build a better healthcare system grew out of her upbringing, she explains, as her family participated in foster care and was “wired to give back to the community.” That background led to her design new products and services for the Medicaid population while working on United’s consulting team, which in turn led her and other innovation-focused minds to create Harken.
“We fundamentally believe people deserve to be cared for,” she says. “And if Harken can offer a very different relationship-based primary care experience, we can actually help support people in that care and in that care journey.”
To do so, Harken designed its health centers as a welcoming place for patients to receive care. They also come equipped with cooperative care teams.
In those care teams, health coaches play an integral role, as they support members and their clinicians throughout the entire care journey. Thus, Harken members’ visits to its clinics are generally longer than typical primary visit, Nelson says.
In addition, technology plays a key role when it comes to involving patients in their own care, Nelson says. For example, members are able to view their electronic medical records, complete with their doctor’s notes, on the wall when they visit.
“That is exposed to our members--they get to be part of the care plan and have access to it,” she says.
The health plan portion, meanwhile, stands out from other products offered on the individual market because the insurance is designed around the care provided at Harken Health centers, but also connects patients to a large network of providers and specialists.
Harken, she adds, is also designed differently when it comes to bigger patient-care picture. “I think we look at it a little bit differently than traditional health plans look at total population health,” Nelson says.
The company processes claims and collects information about its members to pass on to care teams like any other health plan, she explains, but the difference is that “it all comes from the local care team level, based on the member’s needs.”