Regence and University of Washington Medicine partner to help reduce a patient’s chronic pain; improving health through personalized, coordinated care
Imagine a lifetime of ear infections with pain growing so severe that suicide seems like the only relief. Related health issues like chronic opioid use and narcolepsy eventually make daily family life and independent living seem nearly impossible.
Regence BlueShield and University of Washington Medicine (UW Medicine) recently teamed up to help a patient through this challenging time. The Regence member, a mother of four children, suffered from immense nerve pain that left her reliant on high-dose opioids. She was referred to Regence’s Collaborative Care Team, which worked in partnership with the patient and her doctors to create a personalized plan of care. And a path forward began to appear.
Better patient health, coordinated care, lower costs
Regence began its Collaborative Care partnerships in 2016, with the goal of better integrating with health care providers to support improved health outcomes and cost savings for patients. Participating providers are paid for care based on quality and results, known as value-based care instead of fee-for-service. UW Medicine is a key partner in this effort, helping improve how health plans like Regence and doctors work together to serve people’s health care needs.
Traditionally, health plans provide care management for people with high-risk, medically complex conditions. The same person may also receive similar services from their doctor. That similar but uncoordinated outreach can be frustrating for the patient, especially if it results in conflicting information.
Through its Collaborative Care Team, Regence works closely with provider partners to use expertise and insights from both a patient’s doctor and insurance. The two sides collaboratively develop a personalized care plan that ensures everyone is working on the same path to improve a patient’s health.
Personalized, simplified health care
“The goal of our Collaborative Care work is to personalize and simplify health care for our members and the communities we serve,” says Catherine Gaffigan, M.D., Regence’s vice president of network management and provider partnership innovation. “The University of Washington Medicine’s partnership has created improvements and better health for our most vulnerable, at-risk Regence members. Together we leverage data, resources and expertise to drive high-value care that improves cost and quality—most importantly enhancing the consumer’s care experience.”
Health care providers continue to move toward value-based payment models where health plans pay for covered services based on the quality of care instead of the number of services provided. Regence pairs Collaborative Care with its value-based payment programs, which incentivizes doctors to treat the whole person instead of specific symptoms or conditions, even in between office visits. Health care providers are empowered with patient information to better understand what’s happening beyond the clinical setting. The result is healthier, happier and more engaged patients who have a much more personalized experience.
“Our ongoing partnership with Regence creates real-life health improvements for some of our most challenging and complex patients,” says Van Chaudhari, administrator of UW Medicine – Population Health Management. “The Collaborative Care work is a different, system-wide approach to care that’s more personalized, coordinated and cost-effective for all involved.” To date, Regence and UW Medicine have collaborated to help over 2,000 patients.
A collaborative path forward
After being referred by UW Medicine to Regence’s Collaborative Care Team, the patient began to see significant improvements with her debilitating pain. The coordination between Regence and UW Medicine helped her access community resources, resulting in better pain management, improved sleep, transportation support and a more hopeful path toward better health overall and time with her family.
“What you do is truly special and something I am so grateful for,” shared the patient with her Regence case manager. “Thank you for listening to me during this difficult time.”