Expected to save Medicare more than $300 million, practices will receive over $120 million from all payers for their performance in 2020
Bethesda, Md. – July 22, 2021 – Today, Aledade announced that its accountable care organizations (ACOs) are projected to have created nearly $830 million in total savings across the health care system over the past seven years, a more than 100 percent increase in the last year. For their performance in 2020, independent primary care practices across the country are expected to receive more than $120 million in direct savings payments across commercial insurers, Medicaid, Medicare Advantage, and the Medicare Shared Savings Program (MSSP).
Despite the many challenges the COVID-19 pandemic presented, independent primary care practices working with Aledade are expected to save Medicare more than $300 million in health care spending in 2020, while delivering high-quality care to over 410,000 Medicare beneficiaries. Individual practices in MSSP will save between $197 and $587 per beneficiary, an amount equating to about 25-75 percent of their fee-for-service revenue. In addition to the MSSP program, primary care practices working with Aledade generated an estimated $74 million in total gross savings in commercial contracts, $35 million in total gross savings in Medicare Advantage, and more than $20 million in total gross savings in Medicaid.
Aledade member practices share in the savings they help create and are projected to receive more than $120 million from all payers for their performance in 2020. $83 million will come from Medicare, an increase of nearly 50 percent from 2019. These payments will provide a much-needed inflow of revenue to keep practices’ doors open beyond the pandemic.
Aledade’s success during this uniquely difficult year demonstrates the resiliency of value-based models and highlights the strength of independent primary care providers for anchoring this type of care delivery.
“This year put primary care physicians to the test, and we admire the dedication of our member practices as they adapted to the ever-changing landscape and provided high-quality care to their communities when people needed it the most,” said Farzad Mostashari, MD, CEO and co-founder of Aledade. “Our projected savings are a direct reflection of our collective effort and mission as we continue to bring this tested model to more independent physicians across the country.”
Aledade supported practices in their delivery of primary care during a year in which access to in-person care was extremely limited. Despite those headwinds, Aledade ACOs continued to grow and excel at delivering quality care for Medicare Advantage members and are expected to earn an average of 4.15 STARS, up from 3.9 STARS in 2019. This was accomplished through Aledade’s year-long focus on key quality improvements, including increasing patients’ medication adherence and improving systematic data collection and sharing– from clinical observations like blood pressure to laboratory data on blood sugar measurements for patients with diabetes.
These projected savings and quality metrics reflect real-world improvements in patient care as Aledade worked to keep continuity of care between physicians and patients during the COVID-19 pandemic. Although the amount of in-person visits declined nationally, Aledade helped fill the gap by expanding telehealth services and maintaining key communication channels to connect with even the most hard-to-reach patients.
Aledade supported robust patient outreach, often to those at highest-risk, to help them navigate the pandemic by encouraging them to stay home; informing them how to safely access care; and educating them about vaccines and their availability. With Aledade’s help, practices went from nearly 0 percent of patient encounters being done via telehealth in 2019 to nearly 40 percent in 2020. As compared to the historical national average of approximately 19 percent, 72 percent of patients in Aledade ACOs completed an annual wellness visit in 2020 as a result of Aledade-driven patient outreach, ensuring they received necessary care in the midst of the global health crisis.
“As I watched many independent physicians across the country struggle financially during the pandemic year, it was an incredible comfort to know that by participating in Aledade’s value-based model, I would be able to look forward to a shared savings payment just when my practice needed it most,” said Dr. Shawn Purifoy, an independent family physician practicing in his hometown of Malvern, Arkansas. “But those savings don’t just represent financial security, they represent meaningful health improvements for my patients that we were able to achieve together with Aledade’s technology and practice support.”
As physicians fought on the front lines to keep their communities safe during the pandemic, Aledade delivered more than $1.3 million worth of personal protective equipment to its national network of independent primary care practices and community health centers. These shipments included 330,000 surgical masks; 170,000 KN95 respirators; 400,000 medical gloves; 110,000 disposable gowns; 31,000 face shields; and 9,000 bottles of hand sanitizer. These resources helped health care professionals at these practices stay safe while they cared for their communities.
Over the past seven years of collaboration between Aledade and its member practices, the development of best practices and workflow transformation has allowed Aledade’s unique ACO model to be replicated across payers and in geographically diverse communities. The model is shown to rapidly improve patient care and produce significant shared savings for our member ACOs. In fact, 90 percent of Aledade’s ACOs earned shared savings last year, with every single ACO that started in 2016 achieving that goal.
Aledade’s ACO network now covers over 1.15 million lives, or patients, across 90 value-based contracts in 32 states with more than 800 participating practices. In addition to rapidly expanding its value-based model to more communities, payers, and populations, Aledade is also leading the industry when it comes to accepting higher levels of financial risk. In 2021, 44 of Aledade’s 99 ACOs are at risk, compared with 32 of 76 in 2020 and 17 of 67 in 2019. Through its successful model, Aledade is able to help independent practices better manage their participation in risk- and incentive-based programs that better align payers and providers to create better patient outcomes at a lower overall cost to the system.
Founded in 2014, Aledade works with independent practices, health centers, and clinics to build and lead Accountable Care Organizations (ACOs) anchored in primary care. Through these practice networks, Aledade empowers physicians to stay independent, focus on their patients, and thrive financially by keeping people healthy. Aledade offers a comprehensive range of capabilities at scale, that includes cutting-edge data analytics, user-friendly guided workflows, regulatory expertise, strong payer relationships, and local, hands-on support from attentive experts. Together with more than 800 participating providers in 32 states, Aledade shares in the risk and reward across nearly 100 value-based contracts representing more than 1.15 million patient lives under management. To learn more, visit www.aledade.com or follow on Twitter or Facebook.