Washington State Health Care Authority signs on with Regence's episode-based payment program

Regence has added its largest client to its value-based Episodes of Care program, with the Washington State Health Care Authority signing on effective January 2022.

Providers enrolled in Episodes of Care are pushed to consider care from an end-to-end perspective and deliver coordinated, quality care at a low cost through the entirety of a care episode, which the insurer said can last from 30 days to a year.

The Health Care Authority is the state's largest healthcare purchaser, Regence said, and its membership includes public employees, school employees, retirees and their eligible dependents. The organization will bring 363,000 people into the Episodes of Care program.

“Our charge with Episodes of Care is to work closely with providers to deliver a better coordinated experience and lower costs for patients,” said Marion Couch, M.D., senior vice president of healthcare services and chief medical officer for Regence, in a statement.

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“Early results and the addition of major employers and new procedures are adding to the program’s momentum and will ultimately help us bring this innovative care approach to more people across our region," Couch said.

To date, the program has reduced episodic costs for orthopedic procedures by 16% compared to what those procedures have cost historically, Regence said. The insurer has also expanded the program to cardiac procedures, gastrointestinal conditions and maternity care.

Providers are reimbursed based on outcomes and cost reductions over the episode of care, Regence said. Episodes of Care is a partnership with Signify Health, a platform that administers episode-based payments and supports providers and health plans in tracking outcomes.

“As we continue our value-based purchasing journey, the Episodes of Care program is a great example of what we want to focus on: delivering improved patient outcomes and experiences, coordinated care, and lower costs,” said Judy Zerzan, M.D., chief medical officer for the Washington State Health Care Authority, in a statement.