UnitedHealth Group, the country’s largest health insurer, is testing an opportunity by launching its own brick-and-mortar provider operations. With 10 primary care centers now open in Georgia and Illinois, the new Harken Health brand offers a high-touch model that includes onsite, licensed, behavioral health specialists.
All clinicians are employees of the health plan enterprise.
According to Chandra Torgerson, Harken’s clinical and population health leader, the model calls for comprehensive care delivered by multidisciplinary teams, and behavioral health is an integral part of the big picture. For example, patients might be screened and treated for mild depression with the PHQ-9 tool during a visit.
“We’ve only been seeing patients for five weeks, but members are engaging with the appointments for the behavioral health specialists,” Torgerson says. “Some days 50% of the appointment slots are for behavioral health visits.”
She says while Harken’s social workers and counselors can provide onsite treatment, major depression, substance use disorder and certain other diagnoses would be referred out to other providers. Harken is hiring from the local areas so many of the counselors are familiar with the communities’ outpatient or residential treatment centers and can make a phone call on the patient’s behalf to book an appointment or intake evaluation. The care team would continue to coordinate the efforts after the handoff.
“The behavioral health specialists practicing onsite participate in our daily care team meetings that include individual patients or families,” Torgerson says. “If we do need to outreach to [other] specialists, we have our network. And we’re looking to find really good partners in the locations where our Harken centers are located.”
Interested referral partners in the Georgia or Illinois market can find provider contact information on the Harken website. The organization is also planning on expanding into new markets in 2017.
Payer as provider
What’s somewhat unique about the model is that members who are enrolled in the Harken health plan have no out-of-pocket costs for care delivered in its own primary care centers. Zero copay visits are common in Medicaid plans but rarely seen in commercial plans.
As with any health plan, Harken members do pay monthly premiums—although the cost could be discounted with qualifying subsidies when the plan is secured under the states’ insurance exchange marketplaces. For care that is not offered within the 10 centers, members would be referred to other UnitedHealth Group network hospitals and doctors.
The classic example of a payer/provider operation is Kaiser Permanente, which is an integrated system that is self-contained—patients are exclusively Kaiser Permanente plan members and only access its own providers. Other integrated systems, such as Geisinger Health System in Pennsylvania, accept other insurance plans.
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