MacroHealth Inks Partnership with Providence Health Plan to Provide Expanded National Healthcare Coverage
October 14, 2021
MacroHealth launched a multi-year partnership with Providence Health Plan (PHP) to help optimize the organization’s national network strategy. MacroHealth is a healthcare IT company that helps health plans analyze and optimize health price data. Once the most optimal provider network(s) configuration has been identified, they will provide access and facilitate the connection. With a single connection to MacroHealth’s platform, PHP has been able to configure its national network solution to best meet the needs of members. Through this process, MacroHealth has helped identify and eliminate unnecessary and wasteful costs while providing expanded national healthcare coverage through agreements with Cigna Payer Solutions and ClearHealth Strategies for every PHP member.
This new network arrangement launched on June 1, 2021. PHP member benefits will remain the same, while creating a comprehensive network strategy through MacroHealth that will allow Providence Health Plan to better manage claim costs, as well as access meaningful claim trends and patterns through MacroHealth’s robust analytics package.
As a part of their network optimization analysis, MacroHealth evaluated several strategic out-of-network partners on PHP’s behalf which resulted in the selection of ClearHealth Strategies. Providence Health Plan will leverage ClearHealth Strategies through the MacroHealth platform when a PHP member requires care outside the PHP Network. ClearHealth Strategies offers several different repricing methodologies which will increase savings and reduce the overall cost to the member regardless of where the care is provided.
“The partnership with MacroHealth gives us confidence that our network strategy provides the best provider experience possible for members,” said Brad Garrigues, chief sales and marketing officer at Providence Health Plan. “Through this collaboration, we were able to take advantage of MacroHealth’s network connectivity platform which significantly reduced the level of effort to operationalize and connect to Cigna Payer Solutions and ClearHealth Strategies.”
Under this new agreement, PHP members gain in-network access to the Cigna PPO network with over one million providers in primary and specialty care, clinics, hospitals, and labs nationwide1. Additionally, members with PHP select plans will have access to the Cigna PPO network if they travel outside of Providence’s core service area of Oregon and Southwest Washington2.
MacroHealth will continue to identify opportunities new strategic network partners for the future to provide further value to PHP and members.
MacroHealth is on a mission to disrupt the way healthcare services are bought and sold by creating intelligent healthcare markets. With a single implementation onto MacroHeath’s secure, cloud-based platform, Payers connect and design national / regional provider network solutions optimized for each unique member group.
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1The Cigna PPO Network refers to the health care providers (doctors, hospitals, specialists) contracted as part of the Cigna PPO for Shared Administration. Cigna analysis of actual providers contracted as part of the Cigna PPO for Shared Administration as of December 2020. Data is subject to change.
2 Applicable market segments: Fully insured: SG and LG (OR domiciled employers only) and Self-funded ASO. Not available to WA domiciled fully insured large groups or individual plans.