Maryland veterans waiting for primary care have a new option: Evergreen Health Care


Peter Beilenson of Evergreen Health Care. (Ricky Carioti/The Washington Post)

Veterans who have been waiting for months to see a primary-care doctor through the Veterans Affairs Maryland Health Care System can visit one of the four Evergreen Health Care facilities that are affiliated with the state’s new health insurance co-op.

Maryland VA officials signed a contract with Evergreen in August to spend up to $485,000 for ongoing primary care for as many as 1,000 veterans. The contract could change based on need.

Adam M. Robinson Jr., VA Maryland Health Care System chief of staff, said in a statement Thursday that the “partnership is a major component of our aggressive action plan to improve patient access.”

VA medical systems are required to see new patients within 14 days after their paperwork is accepted and returning patients within 14 to 30 days of an appointment request. Some states have been accused of tampering with their scheduling to hide backlogs.

An audit of the Maryland VA system this year found no improper scheduling, according to the statement, but discovered that the system was not seeing new patients quickly enough.

Maryland veterans will have the choice of continuing to wait to see a primary-care doctor through VA or seeing a doctor at one of Evergreen’s health facilities in Baltimore, Columbia, White Marsh or Greenbelt.

“It’s totally up to the veteran,” said Peter Beilenson, chairman of the board of Evergreen Health Care and founder of its affiliated insurance company.

Veterans can return for up to six visits a year, Beilenson said, and will be referred back to VA for more serious problems that require a specialist. In addition to general primary care, Evergreen can provide screenings, wellness programs and counseling.

The partnership means a rush of new patients for the Evergreen clinics, where business has been much slower than expected because not enough people have signed up for health insurance through Evergreen Health Co-op, a start-up made possible by the Affordable Care Act.

About two dozen such nonprofit co-ops are operating across the country, with varying degrees of success. They aim to shake up the insurance market by offering low-priced, high-perks plans that can bring down health-care costs.

Unlike other co-ops, Evergreen has affiliated health-care centers for members that focus on preventive care and general wellness.

Evergreen planned to find its customers on Maryland’s online health-insurance marketplace, at which plans from four carriers would be clearly detailed. Beilenson thought Evergreen easily could enroll 10,000 people in the first year.

But the state Web site crashed the day it debuted last year, struggled through the six-month-long enrollment period and is being rebuilt before the next open-enrollment period starts Nov. 15.

Maryland enrolled 72,000 people in private plans, roughly half of the state’s original estimate. Of those, 94 percent chose a plan from CareFirst, a major Maryland-based insurance carrier that often had plans with the lowest premiums.

For the second open enrollment, CareFirst will increase its premiums by about 10 percent to 16 percent, while the other three carriers will decrease premiums. Evergreen’s rates will be about 10 percent lower.

“They grossly underpriced the market on purpose,” Beilenson said of CareFirst in its first year on the exchange. “We’re going to be much more competitive.”

Evergreen has found success in selling coverage to small groups and businesses, offering lower prices and promising to keep those prices for two years. The co-op has 3,600 members and hopes to have 6,000 by the end of the year, Beilenson said.

When reports of long waits for veterans surfaced this year, Beilenson reached out to Maryland officials and offered to treat their patients in his health centers. He said more than 700 veterans in Maryland have been waiting for at least 90 days for appointments.

Evergreen saw its first veteran Friday morning in Columbia, he said, and plans to see many more on Tuesday.

Jenna Johnson writes about Maryland politics, including the General Assembly, the administration of Gov. Martin O'Malley and the 2014 election.
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