Print edition: 
Via Christi Health and insurer Coventry Health Care are partnering in a pilot Medicare insurance program that’s aimed at reducing costs while providing better care to patients.
The program, called Coventry Advantra Total Care, is a collaboration between Coventry and Via Christi, the state’s largest health system.
The three-year pilot program involves Via Christi primary care doctor offices serving as the medical home for Advantra patients. Patients in the pilot program are closely monitored by Via Christi’s primary care doctors and physician assistants, who serve as patient “navigators,” making sure that patients get the services they need but also encouraging them to follow through on the things their physicians order, such as lab tests and follow-up office visits.
“The goal is to fully understand the needs of the patient and make sure the health care that is provided to that patient is optimal,” said Michael Murphy, CEO of Coventry Health Care of Kansas. “You can sort of say we hold their hand … not leaving the patient … to figure it out on their own.”
Murphy said the program has about 600 people enrolled, and he expects that number to increase as the program is rolled out to more of its Medicare Advantage members.
Equally important in the pilot program is a goal of reducing costs for both the insurer and the health care provider. Eleven months into the program, it is showing some promise, a Via Christi official said.
“What I can tell you is … it appears that our overall utilization of high-dollar services are lower,” said Janell Moerer, vice president of business development for Via Christi Health.
Officials think that use of high-dollar services can be greatly reduced by the navigators. By monitoring patient follow-through, for example, navigators can make sure a patient follows up on getting a $2,000 colonoscopy for a precancerous polyp rather than missing an appointment only to face a few months later $100,000 of cancer therapy.
“I think (Via Christi physicians) would tell you navigation is helping,” Moerer said.
A benefit of the pilot program for Via Christi is that Coventry is helping to pay for the patient navigators, where other insurers wouldn’t, she said. Under the Advantra program, Coventry is also paying for annual physical exams and assessments, which can identify health problems earlier, when treatment is less costly, Moerer said.
If the pilot program meets or exceeds expectations, it could eventually be expanded to other Coventry insurance offerings, Murphy said.
The partnership between Via Christi and Coventry can be traced to Via Christi’s sale last year of Preferred Health Systems to Coventry, and later to Kevin Conlin, who left as CEO of Via Christi Health last December to join Bethesda, Md.-based Coventry as executive vice president.
“That was really the genesis,” Moerer said.
