Gabriel Perna | March 16, 2022
After a long run at Blue Shield of California where he served as the senior vice president of growth, Don Antonucci embraced the opportunity to lead Providence Health Plan as its CEO in September of last year.
“When I think about everything that has transpired in health care over the last few years and the opportunities ahead to transform the health system, the integration between providers, payers, and the entire ecosystem, bringing those fragmented pieces together in a comprehensive way … that is really coming to life,” he says.
As such, the Portland, Oregon-based health plan has partnered with numerous organizations to expand its scope, even beyond the large Providence health system. Recently, for example, it partnered with Virta Health, a telehealth diabetes program focused on the highest need patients to improve quality and cost, as well as Kaia Health, a physical therapy program emphasizing an asynchronous, technology supported platform and health coaching. Providence Health Plan also partnered with Cigna last year to expand its provider network beyond its home base of Oregon and Washington.
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Partnerships play into Providence Health Plan’s three biggest priorities, which will drive its strategy for 2022 and beyond, according to Antonucci. These priorities include: leaning into Medicare Advantage, addressing health equity and supporting patients and providers with behavioral health challenges.
Leaning into Medicare Advantage
Providence serves members in commercial plans, Medicare and Medicaid, as well as plans that are not available via the federal exchange for individuals and families. But what has Antonucci most excited is its Medicare Advantage footprint.
“The spotlight right now — and this is coming from CMS — is squarely on quality and value-based care. It’s a competitive space right now and we think competition is good, particularly when the highlight is on quality. We’re primarily in Oregon today, but as we look to expand into other markets, we can leverage and use our integrated delivery system and overall focus on value-based care to draw in members.”
Antonucci says success in these plans comes down to a philosophical notion that suits Providence well. It’s about knowing the patient, serving them with quality care, and simplifying the experience to help ease their way within the health system. “I’m bullish on Medicare Advantage because it really reflects what we’re trying to do and who we are,” he says.
Addressing health equity
To advance health equity among its member and patient populations, Providence Health Plan is leveraging the strength of the large Providence health system. In late 2020, the health system committed $50 million to address racial disparities of care, with a particular focus on COVID treatments and vaccinations.
The health plan, for its part, is helping Providence-based providers access the information they need to address social determinants within their own regions. To that end, the organization sent more than 11,000 questionnaires to providers to collect data about race, ethnicity and language, as well as sexual orientation and gender identity.
“We want to make sure that data is available and usable for the patients that we serve. This is a real tangible step that we’re taking to give people more access to care in the way that they want,” Antonucci says. “A big part of health equity is making sure you have the right data and the right information … but once you get the data, you have to take action. The next step is to go and do things with that. That’s exciting for us.”
Supporting patients and providers with behavioral health challenges
With a rising demand and an insufficient supply, this is an area where health care organizations are putting a lot of focus. Providence Health Plan is no different and is using the integrated system to increase access for members. Like others, Providence is leveraging digital health and technology to help solve some of these challenges.
“When you think about the ability to use virtual care and telehealth for mental health visits, what we’ve done is take that concept and connect it with our delivery system. We have an entire process in place so people can access the continuum of care they need,” Antonucci says.
Providence also extends these mental health efforts to its own caregivers.
“There’s been a lot going on with COVID these last few years. There’s a lot of burnout and stress,” Antonucci adds. “We’re focusing a lot on our population and providing people with the tools and resources to address any mental health challenges they’re having. It’s something we take seriously.”