EdisonHealth Announces Its First Medical Destinations of Excellence

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The EdisonHealth Network LLC has announced its first Medical Destinations of Excellence for spine, heart, valve and transplant surgery. Formed earlier this year, EdisonHealth helps large employers gain access to carefully chosen integrated health systems that specialize in providing high quality and appropriate care to individuals faced with these complex procedures.

Rather than limit its network to high-cost, high-volume academic medical centers, EdisonHealth contracts with leading health systems committed to offering multidisciplinary, team-based approaches in the evaluation and treatment of patients. “The emphasis of our clinical partners is appropriateness,” states Tom Emerick, company co-founder and former vice president of benefits for Walmart. “Let’s make sure the diagnosis is correct, and the treatment is appropriate. Then, when surgery is really needed, these are some of the best places in the world to receive it.”

Members of participating health plans now have preferred access to EdisonHealth’s first five Medical Destinations of Excellence, which include Geisinger Medical Center in Danville, PA; Intermountain Healthcare in Salt Lake City, UT; Mercy Hospital Springfield in Springfield, MO; Oklahoma Heart Hospital in Oklahoma City, OK; and Virginia Mason Medical Center in Seattle, WA. Specific procedures for cardiac surgery will be offered by Geisinger, Oklahoma Heart and Virginia Mason. Spine procedures will be performed by Geisinger, Mercy and Virginia Mason. Transplants will be provided by Intermountain. Additional health systems are still in the due diligence and contracting phases.

“This is a great opportunity for employer-sponsored health plans to help their employees get world-class advice and treatment for complex conditions,” according to Rick Chelko, president of EdisonHealth and The Chelko Consulting Group. “Employers are starting to recognize that they can’t rely on just any provider to properly diagnose and treat these conditions. Often times inappropriate and unnecessary care is harming patients and adding costs, the importance of partnering with proven integrated health systems is more important than ever.”

EdisonHealth extends the exclusive benefits of these hospital agreements to contracted employers and health plans along with a suite of care coordination, claims payment, performance reporting and related services. Plan members of contracting health plans will gain access to heart, valve, spine and transplant consultations and care, which are usually covered at 100 percent without deductible or coinsurance, plus travel, lodging and food for the patient and a caregiver.

The company will also collaborate with members of its provider network to foster continuous improvements in diagnosing and treating complex surgical cases. “Documented variations in treatment, even among high-reputation teaching hospitals, are amazing. Variations in care and outcomes are even more dramatic in rural and regional settings,” says Emerick who was recently recognized by Forbes as one of “13 to Watch in 2013: The Unsung Heroes Changing Health Care Forever.”

According to Chelko, now that the initial provider network is in place, EdisonHealth can move forward on finalizing agreements with a growing list of interested plans and helping members take advantage of the benefit by mid-year. “At a time when most healthcare news is quite somber, we’re pleased to offer a positive solution.”

To learn more about The EdisonHealth Network LLC, contact Rick Chelko at 866-982-7988 or visit http://www.edisonhealth.net.


About The EdisonHealth Network LLC
EdisonHealth provides members of contracting health plans with access to heart, valve, spine, and transplant care at some of the highest-performing clinics and health systems in the United States. The service is offered to organizations with 10,000 or more employees, as well as smaller groups through third party “aggregators.” Participating employers and health plans also receive a suite of care coordination, claims payment, performance reporting and related services. For more information, visit http://www.edisonhealth.net.

About Geisinger Health System
Geisinger is an integrated health services organization widely recognized for its innovative use of the electronic health record, and the development and implementation of innovative care models including advanced medical home and ProvenCare® (“warranty”) program. The system serves more than 2.6 million residents throughout 44 counties in central and northeastern Pennsylvania. The physician-led system, which includes a 1,000-member multi-specialty group practice, seven hospital campuses, two research centers and a 448,000-member health plan, repeatedly garners national accolades for integration, quality and service. For more information, visit http://www.geisinger.org.

About Intermountain Healthcare
Intermountain Healthcare, based in Salt Lake City, Utah, is a nonprofit system of 22 hospitals, 185 medical clinics, a Medical Group with more than 1,000 employed physicians, a health plans division called SelectHealth, and other health services delivered in Utah and Idaho. Intermountain is widely recognized as a national leader in transforming healthcare through high quality care and sustainable costs. Intermountain's flagship hospital, Intermountain Medical Center, is a 454-bed tertiary hospital that serves as a Level I trauma center caring for the most critically-ill patients from throughout the Intermountain West. The Intermountain Medical Center Transplant Program is the most comprehensive thoracic and abdominal organ transplant program in the Intermountain West. The program includes heart, kidney, liver and pancreas transplants. LDS Hospital is home to Intermountain's nationally-recognized bone marrow transplant program and is a pioneer in pulmonary and cardiac care. For more information, visit http://www.intermountainhealthcare.org.

About Mercy Hospital Springfield
Mercy Hospital Springfield is a 914-bed referral center, and is part of Mercy Springfield Communities, which includes five regional hospitals in Lebanon, Aurora, Cassville, Mountain View and Berryville, Ark., as well as Mercy Clinic, a 500-plus physician clinic with 70 locations throughout the region. It is part of Mercy, which is the sixth largest Catholic health care system in the U.S. and serves more than 3 million people annually. Mercy includes 32 hospitals, nearly 300 outpatient facilities, 39,000 co-workers and 1,900 integrated physicians in Arkansas, Kansas, Missouri and Oklahoma. Mercy also has outreach ministries in Louisiana, Mississippi and Texas. For more about Mercy, visit http://www.mercy.net.

About Oklahoma Heart Hospital:
Known for focusing on the patient and family experience, Oklahoma Heart Hospital (OHH) is consistently recognized as a national leader in patient satisfaction. In addition, OHH ranks in the top 1% in the nation in cardiac procedural volumes, and the top 6% in quality outcomes for cardiac surgery. As a physician owned hospital, OHH is better empowered to connect the practices of the organization to the needs of the patient. Through long-standing integrated partnerships with the Oklahoma Foundation for Cardiovascular Research (OFCR), OHH provides its patients with access to unique medicines and devices not readily available at other hospitals around the world. Founded in 2002, expanded in 2010, Oklahoma Heart Hospital’s "Ok Heart" network is one of the largest cardiovascular programs in the United States, consisting of 2 hospitals, 65 cardiologists, and 60 clinics in rural and metro locations across the great state of Oklahoma.

About Virginia Mason Medical Center
Virginia Mason Medical Center, founded in 1920, is a nonprofit regional health care system in Seattle that serves the Pacific Northwest. Virginia Mason employs more than 5,600 people and includes a 336-bed acute-care hospital; a primary and specialty care group practice of more than 460 physicians; satellite locations throughout the Puget Sound area; and Bailey-Boushay House, the first skilled-nursing and outpatient chronic care management program in the U.S. designed and built specifically to meet the needs of people with HIV/AIDS. Virginia Mason was the first health system to apply lean manufacturing principles to health care delivery to eliminate waste and improve quality and patient safety. To learn more about Virginia Mason Medical Center, please visit VirginiaMason.org or Facebook.com/VMcares or follow @VirginiaMason on Twitter.

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Austin Chelko