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Maryland Insurance Cooperative Taking Root

Christopher Cheney, for HealthLeaders Media, May 21, 2014

Evergreen Health is the only health insurance cooperative that employs physicians itself rather than link to provider networks. Evergreen embraces telemedicine and offers a wide range of services through primary care medical homes.


Trotter

Peter Beilenson, MD, MPH
CEO of Evergreen Health
Photo: Har Sinai Congregation (Facebook)

Innovation is the central issue in economic prosperity.—Michael E. Porter

For many years, Peter Beilenson, MD, MPH, has advocated for single-payer financing of US healthcare.

Now, he runs an insurance company.

Beilenson is president and CEO of Evergreen Health, one of two dozen insurance cooperatives formed with support of the Patient Protection and Affordable Care Act. Evergreen is the only PPACA-spawned cooperative with a health services delivery network.

The health plan business model at Evergreen is closely tied to the PPACA individual and group exchanges. Doctors are salaried in Evergreen's healthcare delivery system, which has been formed with the primary care medical home model. Evergreen medical homes embrace telemedicine and offer a wide range of services including primary care, wellness programs, home monitoring of chronic diseases such as diabetes, and preventative services.

The average size of an Evergreen primary care physician's patient panel is about 1,400. Nationally, the average is 2,200, according the Center for Excellence in Primary Care at the University of California, San Francisco.

Evergreen has its roots in the Healthy Howard Plan, which Beilenson helped launch in 2008 as the top health officer in Howard County, MD. Healthy Howard targeted 2,000 uninsured individuals. The plan offers primary care with a monthly premium of about $65. In addition to affordable rates, the plan features face-to-face health coaching.

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