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04.29.2019

The Importance of Payer Partnerships in Value-Based Care

by Sean Cavanaugh, Chief Administrative Officer and Alex B. Blum, MD Vice President of Strategic Partnerships

Recently, Aledade announced a new agreement to expand value-based care in Delaware, West Virginia, and Utah. Aledade has now signed 24 value-based agreements covering commercial fully insured, self insured, Medicare Advantage, and Medicaid lives. Our providers now have over 260,000 attributed patients in these contracts (in addition to over 300,000 lives attributed through the Medicare Shared Savings Program). We are proud to be bringing high-value care to more people across the country.

PUTTING INDEPENDENT PRIMARY CARE PHYSICIANS FIRST

Aledade’s primary goal is to maintain independent practices as the foundation of our health care system. We help independent physicians succeed in value-based care arrangements. We start by enrolling them in the Medicare Shared Savings Program, but our physician partners want to provide high quality care to all of their patients regardless of their insurance. So, simply signing up for a Medicare ACO is not enough. We discuss with our physicians their goals and then find partnerships with other payers that align with those goals. 

By taking a practice-centric approach, we ensure that the physicians in our network have a voice at the negotiating table with payers. Historically, primary care providers, particularly those in small and independent practices, have not had the opportunity to voice their opinions to national payers and, therefore, had little control over the design of  through value-based incentive programs. We’re changing that. And our payer partners welcome the opportunity to hear from primary care providers committed to transforming the care of their patients. 

THE RIPPLE EFFECT

Part of what makes the Aledade approach to payer partnerships unique is the ripple effect of value-based care throughout the physician’s patient population. Every time we sign a contract, the payer agrees to share claims data with Aledade and our partner physicians; for the first time, our providers can see in the Aledade population health tool, our “App,” the opportunity to improve the health and cost of their patients. That’s important because it allows physicians to practice medicine the way they have always wanted to. When we establish ACO agreements with payers, we enable physicians to apply new workflows to these payer’s members. Providers can then use data-driven insights on more of their patients and be properly rewarded for all the value they are generating. This allows true practice transformation with benefits for payers, providers and patients.  

EVERYONE WINS

Our commercial contracts are good for doctors, good for patients, and good for society, because these contracts may generate revenue when patients get better care at lower cost. Aledade is proud to help align these interests in all of the work we do with practices and health plans.

Payers, physicians, patients, and Aledade all want the same thing—the best possible care at the lowest possible cost. We are excited to partner with Aetna so our providers in Delaware, West Virginia, and Utah are paid for health and cost improvement and not volume. Now begins the fun work of applying our analytics and practice transformation support so the patients who need extra support and care receive it.

For more information about how to join an Aledade ACO, please email us at outreach@aledade.com.