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eDocTalk article

Legacy adds two Medicare Advantage partnerships for 2018

October 2017

Medicare open enrollment for 2018 begins on Oct. 15 and runs through Dec. 7. During this period, Medicare-eligible patients will select their coverage option for the year. Your offices may experience an uptick in calls as patients signing up for a new plan search for a provider in their new network, and current patients work to confirm any new coverage option is accepted by their provider.

Legacy Health is participating in two Medicare Advantage payor partnerships for 2018, with PacificSource Health Plans and CareOregon. This does not mean these are the only Medicare plans that will be accepted at Legacy clinics and hospitals, but rather these partnerships further Legacy’s efforts to increase the number of lives we care for that are covered by a value-based care contract.

PacificSource Medicare Advantage

Legacy is participating in the PacificSource Medicare Advantage MyCare Rx31 (HMO), and MyCare Rx28 (HMO) health plans. These plans are supported by a value-based agreement with Legacy Health Partners, offering care coordination per-member, per-month incentive payments for primary care providers, as well as clinical integration funding for the network.

CareOregon Medicare Advantage

Legacy is engaging with CareOregon in a risk-sharing contract for Legacy Medical Group primary care clinics to care for members of the CareOregon Advantage Star HMO plan. This arrangement creates a financial incentive for Legacy to provide comprehensive, high-quality care for these members. It focuses on this specific CareOregon Medicare Advantage plan and is separate from the care Legacy provides to CareOregon Medicaid-insured members.

Legacy will add more new Medicare Advantage payor partnerships in the future. As part of Legacy’s care transformation initiative, our goal is that by 2023, 50 percent of Legacy’s revenue will be tied to value-based contracts. These Medicare Advantage partnerships are part of how we will reach that goal.

If you have questions about the PacificSource or CareOregon Medicare Advantage plans and Legacy’s participation in them, please contact populationhealth@lhs.org.

 

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