March 15, 2024
Dr. Laura Theis, president of Central Coast Family Care in Santa Maria, Ca., leads a team of eight physicians and five advanced practice providers in delivering full-spectrum primary care to an underserved community. The practice joined Aledade in 2021 after being referred by a local physician, and Dr. Theis has been a self-proclaimed value-based care “enthusiast” ever since.
“It’s definitely an additional source of income, and not a small one,” she said. “It’s been viewed very favorably by the physicians, and it’s brought the entire staff a better understanding of how we can affect the patient experience. Part of that is due to being more efficient because of the Aledade App, but just as important is making the connection that our office activities really do keep people healthier so that they don’t end up in the emergency room and hospital.”
As Dr. Theis delved deeper into the partnership, she grew to appreciate Aledade’s distinct commitment to collaboration and physician involvement.
“We were quite impressed with the ethics of Aledade, and the mission seemed to align very well with our own,” she said. “Aledade listens a lot and dictates very little. The shared savings distribution formula is discussed amongst the physicians and voted on by the physicians. We choose how we would like the final formula to be every year.”
This emphasis on shared decision-making resonated with the practice as an independent group that wished to maintain its clinical and organizational autonomy.
However, when Aledade sent the practice the early version of a new participation agreement in 2023, Dr. Theis was surprised to find she was not in alignment with some of the provisions. “I don’t think there was any ill intent. It was unfortunately just an oversight; the contract writers didn’t read it from the practice perspective,” she said.
Dr. Theis had concerns with clauses that lacked clear opt-out provisions and ambiguity around the practice’s exposure to potential financial risk. The discrepancy between her collaborative experience with Aledade and the agreement’s terms prompted Dr. Theis to address these apparent discrepancies head-on. She reached out to her market president to emphasize the importance of aligning the agreement with the values and needs of not only her practice, but others within the ACO network.
“Every voice matters, especially when it comes from one of our most committed partners,” Gavin White, market president of Aledade’s California ACO said. “I knew if Dr. Theis had concerns with the language, we needed to take them seriously.”
Her feedback worked its way up the chain to Dan Bowles, Chief Growth Officer at Aledade, who took her concerns to heart and helped guide revisions based on her feedback.
“Our mission – to do what’s good for doctors, patients and society – is embedded in everything we do, including our contract negotiations. We are committed to listening to our partners, being responsive to their needs and protecting their best interests,” said Bowles. “We are grateful for their feedback; these insights help ensure we remain physician-first. And we are particularly grateful to Dr. Theis for helping us to craft an agreement that best serves our nationwide network of primary care physicians.”
In the end, almost all of Dr. Theis’ requests were incorporated into the new network-wide agreement, she said.
“There’s a saying in negotiations: if both parties walk away mildly dissatisfied, then that’s probably a good agreement. But I was not at all dissatisfied. They really did listen and understood what I was trying to say and were able to craft a truly physician-friendly agreement.”
– Dr. Laura Theis
Since that time, the practice has embraced some of the new programs and offerings covered by the new participation agreement, including Aledade’s Advance Care Planning initiative, which engages patients with chronic conditions in important conversations about end-of-life care.
Dr. Theis also cited Aledade’s Core 4 and education around it as being instrumental in improving patient health. The practice closed out the 2023 performance year with an impressive 86% completion rate for annual wellness visits and ED follow-up calls.
The entire Central Coast Family Care team is looking forward to continuing its collaborative partnership with Aledade, and Dr. Theis remains enthusiastic about the future of value-based care.
“More and more Medicare and commercial insurances are moving away from fee-for-service and towards a value-based platform,” Dr. Theis said. “Aledade does an excellent job of supporting that, and I hope our practice continues to thrive and continues to grow in this partnership.”