Starting Jan. 1, 2016, more than 80,000 people in New Hampshire will be covered by a new company jointly owned by their healthcare providers and their insurer.
Boston-based insurer Harvard Pilgrim Health Care and the Lebanon, N.H.-based Dartmouth-Hitchcock health system will partner with Rochester, N.H.-based Frisbie Memorial Hospital and Manchester-based Elliot Health System in the new company, called Benevera Health. The partners will make significant investments in technology systems, analytics, and personnel while sharing financial risk, according to the organizations.
The company is an expansion of an insurance product called Elevate Health, which Benevera President and CEO Corbin Petro said was formed in 2013 by Harvard Pilgrim, Dartmouth-Hitchcock, and Elliott. She said Elevate Health was successful enough in featuring a degree of data sharing and better delegation around care coordination that they decided to take the concept further and form Benevera.
The Benevera care model will leverage a new technology platform as well as care coordination managers deployed throughout the participating systems' facilities. The new technology platform will take data integration further than most payers are now capable of doing by providing both claims data and data from electronic health records, such as physician notes and lab values.
"We're doing what is the holy grail of data integration, which is looking at the EHR as well as the claims data," Petro said, "putting those pieces together and getting a much more complete longitudinal patient experience."
The data from the partnering providers' EHRs will not be fully interoperable between them, she said. It will be normalized at a centralized data warehouse and available through a Benevera population health tool.
Robert Greene, M.D., Dartmouth-Hitchcock's chief population health management officer, said the data infrastructure will not be homegrown – the partners are still in the final process of choosing a vendor.
"I won't name names, but we have spoken with a number of vendors who have national reputations," Greene said. "It'll be high-reliability, tried-and-true, and capable of doing the work."
Petro said the technology platform will underscore the company's philosophy on providing truly coordinated care, which includes the appointment of "physician champions" at each participating site to identify best care pathways, and including more ways to provide outreach to patients.
"Historically, in a care coordination process engaging the patients is by phone and letters in the mail. We'll have the technology to engage with them in different ways and different mediums, and we are also locating the care coordinators geographically throughout the state, so they can be there for in-person interventions if possible," said Petro.
In terms of insights gained, both Petro and Greene said that best practice guidelines and protocols that might emerge from Benevera could also be used among any of the partners' patients who are not covered by the company.
"Obviously, we're using the Benevera Health software for Benevera Health patients," Greene said, but the general principle will apply, and it will probably go both ways. We'll find some things from working on other set of patients we can feed back to Benevera Health."
The partners said about 40 additional staff members were being hired at the outset, most as patient care advocates at the partner hospitals. Petro said that, in addition to the 80,000 fully insured original customers, the company was hoping to also incorporate 75,000 self-insured customers sometime in 2016. She also said that from a joint venture perspective, Benevera Health supersedes Elevate Health, but that Elevate would continue to exist as a narrow-network product.