First Choice Health is a provider-owned and provider-driven healthcare system in Seattle. The system represents the largest independent preferred provider network across eight states: Washington, Oregon, Alaska, Idaho, Montana, Wyoming, North Dakota and South Dakota. More than 100,000 providers, 2,400 facilities and 362 hospitals are in the network, which covers more than 600,000 people.
Jaja Okigwe, president and CEO of First Choice Health, spoke with Becker's Hospital Review about First Choice Health's past year, which included adding 20,000 new members in the fourth quarter of 2018 alone. During his first nine months at First Choice Health, Mr. Okigwe helped launch several initiatives, including an Opioid Prescribing Metrics program, which helps employers prevent and address opioid misuse among staff.
Here, Mr. Okigwe, whose 20 years of healthcare experience include roles at Premera Blue Cross and McKesson Corp., answers questions about adding new providers to the PPO network, developments in its opioid program and more.
Responses have been lightly edited for clarity and length.
Question: What challenges did First Choice Health face when adding new providers to its growing network?
Jaja Okigwe: Keeping provider data current for member navigation is critical. With a network of over 100,000 providers, managing the ongoing changes to physician practice locations, phone numbers and hospital affiliations, as well as maintaining a rigorous provider quality assessment program, are both significant undertakings.
Q: On its website, First Choice Health is described as an "alternative to traditional healthcare." What do you mean by this?
JO: We are an alternative to traditional health insurers and third-party administrators. We focus on the 60 percent of employers who choose to self-insure their employees' healthcare program, and we offer more flexibility and greater satisfaction at a lower cost.
Q: What results have you seen with the Opioid Prescribing Metrics program?
JO: We launched the Opioid Prescribing Metrics program in 2018 focused initially on our larger clients. We have a simple diagnostic which allows us to analyze their pharmacy prescription information and categorize potential problems with opioid use. Most of our clients did fairly well. Some had a concerning number of members taking an opioid with a sedative medication, a combination which can lead to sudden death. This year we are rolling out a confidential new program that will help members who are on high doses of opioids manage the care and treatment of their chronic pain and opioid use disorder.
Q: First Choice Health currently contracts with 362 hospitals across eight states. What's next for the network?
JO: As a hospital- and physician-owned company, we have always had a strong relationship with healthcare providers. Today, many health systems are pushing to take on more risk and launch their own direct-to-employer products. We are increasingly being called to help providers come up with newer product and payment approaches that allow providers to exert greater control over how and where care is delivered. It is forcing us to think more creatively about the role a health benefit administrator plays and how we can increase the connection between patients and providers.
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