Network approach works best for patients

Healthcare is the subject of much discussion these days. An overlooked issue in Idaho is the fact that some people have lost the meaningful interaction with their doctor that helped them navigate a complex process.

Uncoordinated care — self-directed pursuit of health services — is not an effective way to achieve a good health outcome. Patients benefit from the advice and direction from their doctor, who is their best advocate and can be their trusted medical advisor. They need professional medical advice about what to do, who to see and where to go, as they navigate the healthcare maze to identify the most cost-effective path to the best course of treatment.

Self-directed care using Google is not a substitute for your doctor’s advice.

This is particularly important to getting the best value from healthcare treatment. Uncoordinated care can lead to unnecessary services and cost more to patients, raising total healthcare cost and resulting in higher premiums in the subsequent years for all.

Recent research has shown that healthcare coordinated through a primary doctor actually leads to better health outcomes, and it also helps manage costs. In fact, a physician who is familiar with his/her patient enhances the ability to customize treatment and get a successful response. Treatment and response is individualized, so familiarity with the patient’s body is essential to better care decisions.

The individual health insurance plans under the current ACA (Obamacare) are particularly well-suited for this coordinated care approach, because of the escalating cost to members under these plans. Blue Cross of Idaho has taken a leading role in Idaho to introduce this improved option for the benefit of Idahoans

seeking individual health insurance and an opportunity to bend the cost curve.

Kootenai Care Network and Blue Cross of Idaho are working together to help mitigate the medical cost escalation by returning to coordinated patient-centered healthcare that is in partnership with one’s primary care physician. This new partnership combines Blue Cross of Idaho individual and family health insurance plans with Kootenai Care Network (KCN) system of selected providers and facilities to bring members in Kootenai County exclusive access to high-quality care and service.

“Kootenai Care Network is one of nine networks in the state of Idaho chosen by Blue Cross,” David Chambers, M.D., Kootenai Care Network board chairman, said. “Our network is made up of over 450 providers that opted to work together to improve patient care. The Kootenai Care Network is dedicated to improving patient care in our area through physician collaboration, coordinated care with the addition of nurse navigators to help manage patient care, and improved tools that allow greater access and insight to patient health records.”

The partnership between KCN and Blue Cross of Idaho brings the opportunity to provide member-centered care in an integrated system focused on delivering the highest quality, most cost-efficient care.

Members will have personal care providers to give treatment and offer advice and guidance. These outstanding doctors, physician assistants and nurse practitioners are dedicated and held accountable for delivering the highest quality care and directing patients to the best specialty care when it’s needed. They will help patients navigate the confusing system — ensuring quality, cost efficient care while avoiding redundant and unnecessary services that drives up costs unnecessarily and may lead to problems.

Each of us, payers, providers and patients, play a significant role in improving healthcare in Idaho. There’s no silver bullet to solve our healthcare challenges, but a patient-centered care model, focused on the patient-provider partnership, will have better results that benefit patients in the doctor’s office and in their wallet.

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Dr. Rhonda Robinson Beale is senior vice president and chief medical officer of Blue Cross of Idaho.