Indiana Payer Partners with Provider Org to Boost Primary Care Access

Physicians Health Plan of Northern Indiana (PHP) is looking to improve primary care access for members by partnering with healthcare provider Premise Health to open a primary care center for clients and members in Indiana.

The pilot primary care center will be located in Fort Wayne, Indiana, and will be available to PHP employer groups and the members they serve. The center will serve fully insured populations and leverage a value-based care delivery model to improve outcomes and lower costs.

Members with a level-funded or large group PHP plan within the designated geographic area will gain access to the cent.

The collaboration will combine PHP’s population health intelligence with Premise Health’s comprehensive primary care services, according to the organizations.

“Providing convenient access to quality care for our members is a top priority for PHP,” Gary Shearer, president and chief executive officer of PHP, said in the press release. “This center will take the patient experience to the next level with ease in seeing a provider and the opportunity to build a true partnership with a care team for lasting healthy outcomes.”

Integrating primary care into the health plan helps improve care access for members and accelerates the shift to value-based care in the health insurance space. Premise Health will deliver services under a fixed-fee payment model and work with PHP to boost health outcomes, expand healthcare access, and improve experiences for PHP fully insured members.

“Improving primary care access is one of the most important levers organizations can pull to improve health care outcomes overall,” Beth Ratliff, chief operating officer of Premise Health, said. “We look forward to bringing PHP employers and members the type of integrated, whole-person health care that breaks down barriers, closes care gaps, and – ultimately – changes lives.” 

PHP is the first local health plan to offer employers and members a plan with exclusive primary care access, according to the press release.

PHP members will have access to a fully integrated care team with physicians, nurse practitioners, behavioral health specialists, and medical assistants. The center will also offer chronic condition management, biometric screenings, women’s health, referral management, and provider-dispensed medications.

PHP will monitor the successes of the pilot center as it considers launching additional locations in the future. The pilot center is scheduled to open in the fall of 2023.

Ensuring access to primary care can help individuals maintain good health, prevent severe disease, and avoid high medical costs. Payers are in a key position to help boost access for their member populations.

Humana recently signed a five-year agreement with ChenMed, continuing their decades-long partnership and solidifying access to in-network primary care for Medicare Advantage members. The provider organization provides personalized senior-focused primary care at more than 120 locations in 15 states.

Similarly, in October 2022, Cigna partnered with an in-home primary care organization to improve care quality and access for Medicare Advantage members. The value-based agreement allows Georgia, Illinois, North Carolina, and South Carolina members to receive routine primary care services from their homes.