St. Charles announces agreement with PacificSource that will benefit patients and providers

St. Charles Health System announced today that it has reached an agreement with PacificSource that promotes excellence in cancer care, reduces administrative burdens and keeps St. Charles hospitals and clinics in-network for PacificSource Medicare Advantage plans in Central Oregon through 2024. The agreement includes PacificSource’s Oregon Health Plan and commercial insurance plans. 

“We are excited to bring this agreement to our community and believe it addresses many of our concerns,” said Dr. Mark Hallett, chief clinical officer for St. Charles. “We are grateful to PacificSource for working with us to identify creative solutions that we believe will benefit patients and health care providers throughout the region.”

In particular, the teams agreed to focus on reducing administrative burdens for patients and health care workers, initially prioritizing the following innovative ideas: 

  • Beginning in 2024, St. Charles Cancer Center patients will be able to receive care prescribed by their physicians without prior authorization from PacificSource. This change recognizes St. Charles Cancer Center’s stellar record providing care within National Cancer Care Network guidelines. 
  • PacificSource and St. Charles will work together to ensure patients are able to be discharged from the hospital when they no longer need hospital-level care. 

“We are all committed to ensuring Central Oregonians retain access to high quality health care and this agreement is a step in the right direction,” said Matt Swafford, chief financial officer for St. Charles. “This is just the beginning of an ongoing conversation with all of our health insurance partners and we hope the innovative solutions we are piloting with PacificSource will serve as a model for future discussions.” 

Both organizations will monitor these new initiatives throughout the coming year to ensure they are achieving the desired outcomes of reducing stress on patients and families and increasing speed and access to appropriate levels of care, while also reducing the administrative burden on health care providers. 

St. Charles will continue to evaluate participation in Medicare Advantage Plans going forward and has not yet reached an agreement with Humana, HealthNet and WellCare Medicare Advantage plans for 2024. For more information on the traditional Medicare and Medicare Advantage options available in the Central Oregon region, seniors are encouraged to contact their health insurance provider, the Central Oregon Council on Aging at 541-678-5483 or the Oregon Senior Health Insurance Benefits Assistance (SHIBA) at 800-722-4134 option 2. 

Open enrollment for Medicare begins Oct. 15.

About St. Charles Health System

St. Charles Health System, Inc., headquartered in Bend, Ore., owns and operates St. Charles Bend, Madras, Prineville and Redmond. It also owns family care clinics in Bend, La Pine, Madras, Prineville, Redmond and Sisters. St. Charles is a private, nonprofit Oregon corporation and is the largest employer in Central Oregon with more than 4,500 caregivers. In addition, there are more than 350 active medical staff members and nearly 200 visiting medical staff members who partner with the health system to provide a wide range of care and service to our communities.

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