Ochsner Health Network and Walmart to launch new health plan

Louisiana's Ochsner Health Network will form a new health plan to cover Walmart and Sam's Club associates in the New Orleans, North Shore and Baton Rouge areas, the companies announced late last week.

Starting Jan. 1, the Ochsner Accountable Care Plan will cover around 6,600 Walmart and Sam's Club associates who will have access to more than 200 primary care physicians and 1,300 specialists. The health network is Ochsner Health System's clinically integrated network.

"Walmart associates now have a plan that simplifies copays, coordinates care and provides access to thousands of providers in dozens of locations," Dr. David Carmouche, president of Ochsner Health Network, said in a statement.

More health systems are contracting directly with large employers as they look to steer patients to narrow networks that feature lower costs and higher quality care. Ideally, these types of plans incentivize primary and preventive care and reduce emergency department visits.

Some employers have found that they can be more creative in their benefit packages when they cut out insurers. But they can still run into data pitfalls that limit their ability to anticipate and manage the cost of care.

The Ochsner Accountable Care Plan will provide patient engagement specialists via a 24-hour call center as well as case managers for complex patients. Many of the providers in the network use or have access to Epic, Ochsner's integrated electronic health record, which will allow Accountable Care Plan members to schedule appointments and access test results online, the organization said.

The Ochsner Health Network, which launched in June 2015, includes five partner health systems and 30 hospitals. Founding partners include Ochsner Health System, St. Tammany Parish Hospital, Lafayette General Health, Christus Health Louisiana, Terrebonne General Medical Center and Slidell Memorial Hospital.

In addition to Ochsner hospitals and clinics, Walmart and Sam's Club employees in the Ochsner Accountable Care Plan can receive care at St. Tammany Parish Hospital and Slidell Memorial Hospital as well as their associated clinically integrated networks.