Summer 2016

Open Enrollment is here — is this plan right for you?

When Moda first partnered with OEBB seven years ago, we learned a lot about you and your health needs. In 2013, based on that knowledge we first offered you a unique type of medical plan — one that acknowledges how fractured medical care has become and aims to put the pieces back together for you. Since then we’ve continued to improve on these plan options, Synergy and Summit, making them even better for you.

The underlying concept is called a Coordinated Care Model (CCM), but that’s a mouthful. What you need to know is that these plans take a team-based approach to healthcare and work best when you take an active role in your health journey.

”In the past, you may have seen a number of doctors and other providers because these people may not have had a formal way to work with each other,“ explains Moda representative Courtney Burke. With the highly focused Synergy and Summit networks, she says, ”the primary care clinic is at the center, which leads to better integrated care.“

Smart, affordable and focused on you

Even if you have a good relationship with your doctor’s office, you may have felt rushed through an appointment or frustrated by having to explain your health needs to multiple practitioners. That’s less likely to happen to you with our coordinated care plans, because doctors’ success with Synergy and Summit isn’t based on how many patients they see, but rather on how well they manage the health of those patients. It’s an approach that makes you the No. 1 priority, encouraging all of your providers to work together, share information and create treatment plans that work for you.

Synergy and Summit also can save you money — as much as 10 percent compared to Moda’s PPO plans — because you and your family will have lower premiums and lower copays for prescriptions when you use these plans.

A home base for healthcare

We call the primary care clinics that drive Synergy and Summit ”medical homes,“ because they truly are your port in the storm, providing a solid base from which to coordinate your medical needs. One way medical homes do this is by providing care navigators: Nurses who reach out directly to you to plan your appointments, explain your medications and help you follow your treatment plan.

We believe so strongly in the success of medical homes that we require members on Synergy and Summit plans to select one to coordinate their care. The result, Burke says, is that Synergy and Summit members are more proactive about their medical care and feel more empowered in their healthcare journey.

This fall, in addition to the 19 counties already participating in Synergy, the network will expand to include Crook, Deschutes, Douglas and Jefferson counties. Summit will remain in the 12 Eastern Oregon counties that have been receiving this benefit.

Intrigued? Check with your benefits team to see if Synergy or Summit plans will be offered by your employer. You can also learn more at modahealth.com/oebb/.