Providence Health Plan

See schedule oprovidenceat Providence, we use our voice to advocate for vulnerable populations and needed reforms in Health care. We are also pursuing innovative ways to transform Health care by keeping people healthy, and making our services more convenient, accessible and affordable for all. In an increasingly uncertain world, we are committed to high-quality, compassionate care for everyone - regardless of coverage or ability to pay. We help people and communities benefit from the best Health care model for the future - today.together, our 117,000 caregivers (all employees) serve in 51 hospitals, 1,000 clinics and a comprehensive range of Health and social services across Alaska, California, Montana, new mexico, Oregon, Texas and Washington. The Providence family includes:-providence across seven western states-covenant Health in west texas-providence facey medical foundation in los angeles, ca-kadlec in southeast washington-pacific medical centers in seattle, wa-swedish Health services in seattle, wa realizing our missionto deliver true Health to our members, php focuses on innovation, personalized medicine, collaboration among diverse partners, and stability. Php also participates in Health measurement programs, including healthcare effectiveness data and information set (hedis), which allow us to benchmark our care and service, and implement a targeted approach to improving member Health and service. Php's Oregon commercial line of business received a 4.0 rating from the national committee for quality assurance (ncqa) for the 2021-2022 ratings. Providence continues to be recognized as the highest rated commercial ppo Plan in Oregon. For Plan year 2021, php's Oregon exchange line of business received a 4.0 rating for the quality rating system (qrs). Providence offers Providence administrative services only (aso) for large groups capable of self-funding the risk experience of the group, but also want the dedicated and compassionate service that Providence delivers for claims administration, member service, and skilled medical management. Aso groups are offered options for a wide array of Plan benefits, including preventative choices aimed at improving employee Health and wellness, alternative care, group Health reporting and metrics, access to Providence provider networks and proprietary Health innovations, and consumer choice plans which offer qualified Health savings account (hsa) options. Grants and allocations to 501(c)(4) organizations: see schedule iat Providence, responding to community needs, especially in times of crisis, has always been at the heart of the healing care provided by our family of organizations. Providence Health Plan's priority remains the Health of our members and our communities. Providence Health plans community benefit giving focus areas are:1. Social determinants of Health and wellbeing focused areas include housing , transformation and food security.a. Examples include ensuring the food pantry at family promise of tualatin valley was stocked through $9k in donations and creating gift basics for new mothers to help care for the basic needs of newborns and children with $5k in donations to the family building blocks organization.2. Chronic conditionsfocused on prevention of obesity, diabetes, hypertension and depression.3. Behavioral health/wellbeing and substance use disordersfocused on prevention (particularly for youth), culturally responsive care and Health education, social isolation and community building.a. In this area, Providence Health Plan supported 7+ community organizations including $25k to rose haven, a portland metro area recovery center for those suffering from substance use disorders. Providence Health Plan also donated $12.5k to the for a substance use treatment center and more than $20k to portland metro area community org, central city concern.4. Access to care focused on services navigation and coordination, culturally responsive care and oral health.a. Php donated $75k to the black parent initiative to support access to high-quality healthcare.in 2022 Providence Health Plan gave more than $600k in funds to support these focus areas.in 2022 we completed several community outreach projects and pilots aimed at improving quality of life for those we serve as well as access to care.targeted diabetes interventionin 2022, the Providence Health Plan care management team completed targeted outreach to identified members from a Health equity lens that were at risk for or currently living with diabetes. Members were offered interventions including: - enrollment into both care management and Health coaching to work with a certified diabetes educator and registered dietician.- targeted education specific to diabetes and/or hypertension.- diabetes goal setting.- medication interventions including identification of barriers and goal setting.- coordination of member community or resource needs as identified.- provider interventions to support identifying barriers and connecting members to primary care, specialty or behavioral Health providers.- additional areas of focus in cohort 2:- statin therapy: identifying and educating members on importance of statin therapy.- food disparity intervention referral to members with food insecurities who lived in geographic scope.- retinal eye screening: ensuring members completed or have scheduled appointments for retinal eye screens.food disparity pilotprovidence care management food disparity pilot offered a tiered approach to providing meals. Enrolled members received 8 weeks of support from care management and/or Health coaching, including weekly one-on-one assessment and intervention. More than 90 members received support in one or more of the following ways:- independent meal prep/gift card tier.- member mailed a $50/week gift card to use on food (gift card restrictions: tobacco, alcohol, firearms, lottery).- partial dependent meal prep/ready to prepare meals tier.- member received ready to prepare food boxes, delivered by albertsons/safeway containing 6 meals/week (boxes will contain 3 meals/2 servings = 6 meals and choice of fruit).- unable to prepare meals/ready to consume meals.- member received 6 ready to eat meals/week and choice of fruit, delivered by albertsons/safeway (contains 3 fresh meals and 3 frozen meals).82% of members who completed the program had an improvement in their food disparity score and 90% of members said that the intervention gave them confidence to prepare meals and utilize community resources.our telehealth provider policies were significantly expanded to reduce barriers to care and to encourage the use of telehealth services by our members and provider partners. We also added virtual capacity so that more of our providers can be seen quickly.the behavioral Health concierge program allowed members suffering from behavioral Health issues to be seen more quickly more than 70% of people utilizing the service were seen withing 48hrs of their request. Because this program is virtual with expanded hours, it increased access and reduced barriers to care.