Michigan-based insurer Priority Health has teamed up with Garner Health, a digital platform that steers patients to high-performing doctors to lower costs, the companies announced on Wednesday.
Priority Health serves 1.4 million members in Michigan, Indiana, Ohio and Wisconsin. The new partnership will support both self-funded and fully funded employer groups, and will become available starting August 1.
The partnership seeks to make it easier for Priority Health’s members to find high-quality physicians in their area. Garner Health has a dataset of over 60 billion medical records that helps identify the best quality doctors. When members choose high-performing providers through Garner’s dataset, their employer then covers most or all of their out-of-pocket costs. This incentivizes employees to choose better doctors and lowers costs for employers by avoiding unnecessary procedures.
“This partnership puts Garner’s provider quality data to work for Priority Health’s members at scale,” said Kirk Czonstka, senior vice president of strategic alliances at Garner, in a statement. “When we steer members to top providers in their existing network, employers see measurable results on average, a 12% net reduction in healthcare spend in the first year, without shifting costs to employees or changing their benefit plans.”
Priority Health chose to partner with Garner Health because they’re an “established leader in provider quality analytics,” said Chase Osbourne, senior vice president of employer solutions and innovation for Priority Health.
“Garner stands out for its unmatched claims-based analytics, which evaluates the full patient care journey and delivers visibility into provider performance,” Osbourne told MedCity News. “Their incentive model is especially compelling—it motivates members to seek highly rated care by covering out-of-pocket costs, which aligns perfectly with our goal to improve outcomes and lower costs without causing disruption. Their robust data and seamless member experience made them the right choice for Priority Health.”
In working with Garner Health, Priority aims to provide significant cost savings for employers, Osbourne added. In addition, the insurer wants to increase member engagement and improve health outcomes.
The Power of Real World Data to Study Women’s Health at Scale
Veradigm examines key clinical trends, comorbidity profiles, and treatment trends across adolescence, reproductive years, and peri-/post-menopause. Download it today!
“Ultimately, we’re committed to providing a smarter, non-disruptive solution that benefits both employers and their employees. … Our shared vision is to create a simple, engaging experience that helps members make informed choices and drives positive health outcomes,” he said.
This announcement comes shortly after Garner Health announced a $100 million Series E raise led by Index Ventures in May. The company’s CEO, Nick Reber, told MedCity News that Garner was created out of his own frustrations with the healthcare system. Reber had back pain, which was misdiagnosed and ultimately led to four surgeries.
“I got to see how healthcare really works from the inside, and I just got really passionate about it, and decided I want to aim my career at trying to solve the problems,” he said. “What I got convinced about as I was digging in is that we all know healthcare is messed up, both in a cost and quality and health outcomes perspective, but what I think is not super well understood is why. My view became that healthcare is messed up [because of a] lack of consumer incentives and consumer information.”
Photo: Dragon Claws, Getty Images