Network of health care providers, insurers, help provide low-cost care

After looking into the effects of Eastern Idaho Regional Medical Center being labeled as an out-of-network provider by Blue Cross of Idaho in 2017, we looked at the possibility of it happening at Portneuf Medical Center in Pocatello. The hospital said it wouldn’t happen.

The reason: The Portneuf Quality Alliance. It’s a network that involves PMC, health care providers and health insurers like Blue Cross of Idaho. How it works is the providers assure quality care is given at an affordable cost. Then, with the data provided to insurers showing it, affordable premiums are assured.

Essentially, the network helps get all health care players on the same page.

“If there is going to be a way to save money, hospitals, physicians and payers have got to come to the table,” said Daniel Ordyna, CEO of PMC. “Collectively, they’ve got to be able to deliver a solution.”

PMC has been using the PQA system on its employees for around four years. Since introducing it, the hospital has found it hasn’t needed to increase premiums a dollar year-to-year.

Ordyna said that is proof the system can work on a broader scale to provide low-cost quality care for people.

“The more and more we learn how to do this, the more and more we want to expand it. We want to be able to deliver this type of arrangement with everyone in eastern Idaho,” he said.

PQA services have been expanded for people using Blue Cross of Idaho plans on the Your Health Idaho exchange. If success is seen there, the next plan is to expand it to businesses offering health insurance to their employees.

Its service area is Bannock and Bingham counties. You can find out more information on the PQA website here.