Health network growing strong

Posted: Saturday, Nov 01, 2008 - 08:22:11 pm PDT
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By RICK THOMAS
Staff writer 

RICK THOMAS/Press Dr. Donald Chisholm, right, is a member of the North Idaho Health Network, which helps provide health care at lower cost. Also pictured are staff members, from right, Becky Foland, medical assistant, Chris Rusho, scheduler, and Stephanie Armstrong, certified medical assistant at Ironwood Family Practice in Coeur d'Alene,

NIHN reaches 17,000 clients, includes more than 265 physicians

The future was now a mere 15 years ago when a group of North Idaho health care professionals decided to take steps to control their own destiny, and that of their patients.

What started with only a couple of members has now grown to 17,000 clients in the North Idaho Health Network, a group of about 90 percent of the area's providers and all the region's hospitals.

"Health care is changing a lot now, nationally and locally," said Richard McMaster, executive director of the nonprofit organization. "There is more technology. That is good news and bad news. It keeps people alive, but it costs money. The more equipment people have the more they have to use it."

NIHN emphasizes quality based on outcomes, recognizing that cost savings in health care result from efficient delivery of care designed to achieve the best possible results.

"Physicians want to practice according to the evidence," McMaster said.

The community physicians and hospitals of the five North Idaho counties formed North Idaho Health Network in 1994.

The network includes more than 265 physicians and the nonprofit community-owned health centers, including Kootenai Medical Center, Bonner General Hospital, Boundary Community Hospital, Benewah Community Hospital and Shoshone Community Hospital.

"The biggest accomplishment has been getting physicians and hospitals in the five northern counties to see what they can do to improve health care, said Mike Dixon, M.D., medical director of NIHN and one of the founders.

They began when there was no managed health care in North Idaho, and Blue Cross and Blue Shield were just starting up.

"Physicians here decided they should see how to position themselves," Dixon said. "They were concerned about how health care would be managed here. They decided managed care was OK, but employers were asking for accountability about how their dollars were spent."

Contracts with Blue Shield and Blue Cross allowed them to have a say in management, he said.

"It required a lot of trustbuilding between us and the insurance companies and hospitals," Dixon said. "It took several years. Now we can have a positive effect on health care."

The network has a health insurance plan with companies such as The Hagadone Corp., school districts, Kootenai Medical Center and North Idaho College to provide access to quality health care at lower prices. They estimate about 12 percent in overall savings.

A key service of the organization and its eight employees is wellness programs.

"It is a very sophisticated program based on evidence of what works," McMaster said. "It starts with a personal wellness profile, a survey tool to get an idea of where there is a need to work on. Just taking and having the information can help."

It helps identify opportunities for savings, said Bo Larsen, community and business relations director. For example, if insurance is being over-utilized, it may point to a problem.

"A healthy employee makes a healthier bottom line," he said.

The survey can help avoid lost workdays, as the wellness profile can be a measure of productivity, McMaster said.

"People who aren't as healthy aren't as productive," he said. "They either don't show up, or work fewer hours."

The survey lists the top 10 health problems to work on, and that information is used to design wellness offerings for the year at NIC, said Wade Larson, human resources director for the college, which spends $4.5 million per year on health care. The fees they pay, $40,000 per year, are recouped immediately just off discounts, he said.

"If we didn't pay we would get nailed with higher rates," he said.

Participation in the wellness profile does not lower copays or deductibles, but participants can get back $700 per year, or $1,400 per family in a health reimbursement account.

That includes $300 for an affidavit of non-smoking, $200 for an annual medical exam and $100 per semester for taking wellness classes and exercising regularly.

"NIHN has been working very hard the past six months for added value for clients," Larson said. "They are involved as partners. We appreciate that very much."

An Employee Assistance Program also offers basic mental health and crisis intervention, such as marital or financial problems, and can help prevent overuse of insurance, McMaster said.

"Very few people want to go to a doctor for mental health issues," he said.

Employers pay, because people having major problems are not as productive. Untreated mental health problems can lead to health issues and higher medical costs, he said.

The program looks at four components: a good social system, mental health, physical exercise and nutrition, and spiritual. The latter is a broad category, not religious or church affiliated, McMaster said. It can be something as basic as a walk in the woods.

"Part of being yourself is having quality time to yourself," he said.

The network puts some of the control of medicine back into local hands, rather than Lewiston or Boise, Dr. Donald Chisholm of Ironwood Family Practice and chairman of the board. It influences product design and adds more logic into insurance industry coverage.

"It gives us the ability to order what the patient needs, versus insurance company edicts on what they can't or must do," he said. "It helps optimize patient care."