Leading Southeast Idaho Health Care Group Adopts New Care Management Model

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POCATELLO, Idaho – Portneuf Quality Alliance (PQA), a southeast Idaho-based network of physicians and providers, is accelerating its drive to improve patient care and better manage costs by embracing Regence BlueShield of Idaho’s Total Cost of Care (TCC) solution. It’s the first agreement of its kind in the region.

Regence’s TCC is an accountable care model that empowers physicians with highly detailed medical cost and quality information to help them improve outcomes for their patients. Regence offers aggregated data from the provider group’s patients and works with the groups to show them ways to offer the same quality of care at lower prices. This can be accomplished, for example, by seeing where patients go for after-hours medical care. By working with PQA to raise patient awareness about the use of urgent care centers and discouraging overuse of emergency rooms for routine medical care, significant savings can be achieved. Additionally, significant savings can come from reviewing the cost differences between where services are rendered, and examining prescription practices, with an eye toward encouraging increased use of generic versus name-brand drugs.

“We are committed to using data more effectively to improve patient care and deliver value. Our agreement with Regence allows us to more comprehensively collect and analyze clinical and claims information to get a better understanding of how to best manage our patients,” said Dani Jones, executive director of Portneuf Quality Alliance.

The group, with its network of more than 600 providers, believes health care has gotten too expensive, too wasteful, less patient friendly and is often not evidence-based. That’s why it long ago chose to attack these problems by establishing quality goals and objectively measuring progress towards those goals using data.

“Regence has shown us how the tools they offer can provide deeper and richer insights on how we can more effectively use resources to achieve better outcomes for our patients. We hope it will be a positive experience for us to partner with Regence representatives as we work towards the common goal of improving care for the patients,” Jones added.

Regence’s TCC includes a shared savings arrangement tied to physicians achieving specific quality metrics and a reduced cost trend. The agreement between Regence and Portneuf Quality Alliance is for three years, which is designed to allow the group time to integrate what they learn into treatment approaches for their patient population.

“We’re delighted to be able to work with Portneuf Quality Alliance to bring Total Cost of Care to southeast Idaho. Like Regence, the alliance is committed to pursuing innovative approaches to transform health care to become more person-focused and economically sustainable,” said Scott Kreiling, president of Regence BlueShield of Idaho. “Portneuf Quality Alliance has already done so much to sharpen its focus on delivering value and raising the quality bar for its patients. It’s highly satisfying to work alongside them to take even bigger steps toward advancing our common interests for quality, affordability and sustainability.”

This new TCC agreement is the latest example of the successful roll-out of the comprehensive Accountable Health strategy within the Regence family of companies in Idaho, Utah, Oregon and Washington. Since 2007, Regence has worked with providers, employers and individual members throughout its four-state region to implement innovative collaborative care models.

About Portneuf Quality Alliance

The Portneuf Quality Alliance is an innovative health care team dedicated to utilizing the medical resources of the community to bring higher quality medical care, enhanced medical value, improved medical outcomes, reduced medical costs, and increased collaboration between the men, women, and children of southeastern Idaho and their medical providers. Learn more at http://portneufqualityalliance.org/.

About Regence BlueShield of Idaho

Regence BlueShield of Idaho, based in Lewiston, has been serving Idahoans for nearly 70 years and now provides more than 141,000 members with comprehensive health insurance solutions. As a nonprofit mutual insurance company and independent licensee of the Blue Cross and Blue Shield Association, Regence is part of a family of companies dedicated to transforming health care by delivering innovative products and services that change the way consumers in Idaho and nationwide experience health care. For more information, please visit regence.comfacebook.com/regenceblueshieldofidaho or twitter.com/regenceidaho.