While the nation is still divided on whether President Barack Obama’s healthcare reform will bring down costs, some have risen above the controversy, focusing instead on opportunities provided by the changes.

“It’s the law of the land,” says Scott Wilkerson, president and chief executive officer of Physicians Health Plan (PHP). “Our job is not to say whether it is right or wrong but to take advantage of it as a company for our customers.”

That is exactly what PHP officials have done. Under the federal healthcare reform law passed earlier this year, the Affordable Care Act requires each state to have a high risk pool in operation, effective this month, to provide coverage to the chronically ill without limitations for pre-existing conditions. PHP was among those bidding for the federally subsidized program and was awarded the contract from the U.S. Department of Health and Human Services this past August. The state-implemented pool is being funded through subscriber premiums and an estimated $140 million from the federal government. The contract runs through January, 2014, at which time all insurers will be required to accept individuals regardless of pre-existing conditions. The Office of Financial and Insurance Regulation will oversee PHP’s handling of the transitional program.

Appropriately named Physicians Health Plan, the insurance provider was started almost 30 years ago in Lansing by a group of physicians from Sparrow Health Systems. The premise was to find a way to combat skyrocketing healthcare costs but still provide high-quality patient care.

“These were forward-thinking doctors who got together to develop a not-for-profit health plan,” says Wilkerson. “Our goal as a health insurance provider is to make sure all parts of the healthcare system are working together to get care delivered at the right time and the right place.”

Wilkerson says PHP differs from other insurance companies in a number of ways, including its focus on transparency of information. “We provide doctors, hospitals, and members with lots of data and information on the outcomes of healthcare so they can make an educated decision on the right course of treatment.” Wilkerson says the insurer also differs from others in offering disease management programs. He uses a patient diagnosed with asthma as an example. “We send newsletters and reminders for checkups. We know what they need and we routinely provide the care and information to avoid critical problems and long hospital stays.”

In addition, Wilkerson says PHP’s treatment doesn’t end there. The insurer offers case management, where doctors track the progress of patients and make adjustments as needed. In cases of chronic health conditions that can be particularly important. “We have constant contact with the patients to make sure they’re sticking to the healthcare plan and to make sure they’re OK,” Wilkerson notes. He also says that type of one-on-one care helps provide better outcomes for the patient and keeps costs down.

Most importantly, Wilkerson says, is Physicians Health Plan is able to lower costs for subscribers by offering the services of a network of providers—all licensed and in good standing. They focus on preventative care. “We screen for lead poisoning and send reminders to make sure kids get the immunizations they need. We focus on overall wellness,” Wilkerson stresses. “It’s a comprehensive approach to healthcare that distinguishes us from HMOs [health maintenance organizations] and other carriers.”

PHP’s programs have not gone unnoticed. In addition to being chosen by the federal government over a number of other insurers to manage the high-risk pool, PHP was recently recognized as the state’s best health plan for consumer service in 2010 by a Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey. Wilkerson accepted the honor with pride. “Receiving Michigan’s number one ranking for customer service reflects our staff’s dedicationd to providing quality care and service.” He credits the PHP team for the award. “I’m exceptionally proud of their hard work and commitment to each and every one of our members.”

Health policies are available to individuals but PHP caters mostly to businesses. “We offer a wide array of options to meet their needs.” Wilkerson adds there are big advantages in insuring groups rather than individuals. “The bigger the pool of people you’re covering, the better the cost outcomes you can get.” In addition to health savings accounts, pharmacy coverage is also available. Right now, PHP does have approximately 70,000 members and generates about $220 million in revenues annually. “We offer everything from full coverage to high deductible health plans.”

But Wilkerson says even they’ve seen a downturn due to the economy. He says some businesses just trying to stay afloat have dropped their coverage for employees or significantly scaled back on benefits. Others were forced to lay off workers and suspend hiring more. “Those workers no longer have access to healthcare,” Wilkerson says. “In addition, we don’t have employers moving to the region or starting businesses here.”

Physicians Health Plan currently has 110 employees, but Wilkerson expects that number will rise as healthcare reform is phased in. He also expects costs to rise a bit as well. “Some of the new mandates could increase the cost of insurance. Added regulation often requires more people for enforcement, and other people costs.” Again, though, Wilkerson prefers to think of the situation as a glass half full. “The company will grow to meet demand and regulation and that means more jobs for the mid-Michigan area.”

Wilkerson does not anticipate difficulties complying with the new reforms. He says PHP already offers a more comprehensive model of coverage than other insurers. “We’ve already been offering coverage to dependents to the age of 25. The new requirement is age 26.” He says he looks forward to standardizing some of the business practices various carriers use.

Wilkerson also doesn’t anticipate any major changes in the way PHP does business heading into the future. He says PHP will always offer the best benefits available at the best prices, though those prices are likely to rise for a while. “Healthcare costs are rising faster than the rate of inflation. Prices are going up faster than we would like because we haven’t seen a matchable solution at this point.” But Wilkerson has hope for the future. “We’ll just keep trying to ‘bend the trend’ to keep costs as low as possible,” he says. “If we don’t, we’ll lose customers and that’s not an option.”