The policy, ElevateHealth, is the first of its kind in the state and seeks to provide both employers and employees with a high standard of care at a lowered premium cost, according to a DHMC press release. The policy, which takes effect Dec. 1, offers savings of at least 10 percent compared with other plans offered by Harvard Pilgrim Health Care.
"We decided that one of our goals is to be able to provide high-quality care at lower cost," Stephen LeBlanc, DHMC executive vice president for strategic and network relations, said. "Employers are struggling with the cost of health care so we figured that working together we could come up with an insurance product that would be lower cost and comparable."
The policy will cover a network of over 400 primary care doctors and 2,600 specialists. These health care professionals offer services at DHMC and its community group practices, Elliot Health System and other providers including those in Derry, Keene, Nashua and New London.
ElevateHealth's creators hope it will be an innovative insurance option and provide more coordinated care for patients covered by the various providers, LeBlanc said.
"Provider and insurer [are] coming together to be able to offer something and design something that best meets the needs of employers and their employees our patients," he said.
The policy is unique in the areas of care coordination for patients, LeBlanc said. The policy gives nurses the roles of both patient advocate and clinical liaison.
Because of the new partnership involved in the policy, the insurance and health care providers have joint responsibility for quality and cost of care. This will provide accountability if costs are higher than expected, LeBlanc said.
While not the partnership's primary objective, the organizations may work toward improving the value of care in Southern New Hampshire in the future, according to the press release. The program may also grow to serve larger employers and will look to expand to more health systems in the future, LeBlanc said.
The network for ElevateHealth was intentionally defined by geography and the partnership creators' desire to effectively coordinate care.
"DHMC and Elliot have had a common goal around this kind of a product so it was logical for us to work together and we wanted to start it fairly small to be able to provide that care coordination," LeBlanc said. "We think it'll probably be more focused on marketing in the southern part of the state."
LeBlanc noted that though ElevateHealth will not be available to everyone because of the network's geographic limitations, it provides another option for consumers.
At the press conference announcing the partnership, DHMC chief executive officer and health system president James Weinstein said the current New Hampshire health system is "unsustainable" and Elliot Health System CEO and president Doug Dean said the three organizations share the "common goal" of helping solve the nation's current health care challenges.
Health maintenance organization plans in the state, like ElevateHealth, saw a three to 9.9 percent loss in value depending on group status from 2008 to 2009, according to the Supplemental Report of the 2009 Health Insurance Market in New Hampshire. In 2009, the average member premium per month for New Hampshire was $398 for large group employers and $394 for small group employers.
Elliot Health System is a nonprofit that includes Elliot Hospital of Manchester. Harvard Pilgrim Health Care is a not-for-profit system of New England.
