Aledade and Anthem Announce New Medicaid Partnership to Bring the Benefits of Value-Based Care to More Virginians

November 30, 2023

More than 150,000 Anthem members across Medicare Advantage, commercial insurance and Medicaid will benefit from Aledade’s model of physician-led value-based care

Bethesda, Md. — November 30, 2023 — Today, Anthem Blue Cross and Blue Shield in Virginia and Aledade, the nation’s largest network of independent primary care, announced the latest step in their effort to expand access to high quality primary care across Virginia, especially in communities facing challenges accessing care. Anthem and Aledade’s collaboration in Medicaid now means that more than 150,000 Anthem members in the Commonwealth of Virginia will have easier access to high-quality primary care, including preventive care and screenings. This partnership will impact more than 80 practices, 15 health centers and 25 rural health clinics across Virginia and covers Medicare Advantage, commercially insured, or Medicaid members.

Aledade is working to bring the benefits of value-based care to patients all across the Commonwealth, especially those in underserved communities and those who receive care through a community health center. Today, the company serves as a vital partner to 15 of Virginia’s 26 community health centers (CHCs) and supports the care of more than 90 percent of Anthem’s CHC members in Virginia. In the federal government’s largest value-based care program, known as the Medicare Shared Savings Program (MSSP), Aledade supports the care of more than 10,000 Virginians who receive care through rural health clinics in the Valley Health MSSP ACO.  The company is currently working with leading CHCs to launch Virginia’s first CHC-only ACO in MSSP next year.

“As a community health center, we understand that value-based care is of great importance to shift the focus of health care to be patient-centered and about striving for the best possible outcome for our patients,” said Barbara Willis, CEO of Hampton Roads Community Health Center. “This kind of care allows us to focus on eliminating redundant care, disease prevention, improving the full patient experience and less unnecessary testing. This not only leads to greater overall medical cost savings, but it has shown to improve the relationships between doctors and their patients.”

Last year, Aledade’s partnership with Anthem’s commercial insurance line of business brought more proactive and preventive primary care to patients across the Commonwealth. Primary care practices and CHCs working with Anthem and Aledade delivered high quality care to patients with diabetes in 2022 – improving their rates of hemoglobin A1c testing by 10 percent to reach 9 out of every 10 eligible patients and achieving high levels of kidney health evaluation for patients with diabetes. Practices working with Anthem and Aledade also ensured that 3 out of every 4 patients eligible for breast cancer screening received a mammogram.

“We are already beginning to reap the benefits from this partnership seeing rural health clinics expand access and offer more preventive care,” said Monica Schmude, President of Anthem Blue Cross and Blue Shield in Virginia. “These physicians are able to focus exclusively on better health outcomes for our members, making a critical difference in the health of our communities.”

“Every patient deserves access to the proven benefits of physician-led, value-based care, regardless of how they get their health coverage,” said Ananya Banerjee, Chief Commercial Officer at Aledade. “Thanks to our unique partnership with Anthem Blue Cross and Blue Shield in Virginia, we are ensuring this high-quality care reaches patients of every age and in every community, so that we can close persistent and troubling gaps in health equity and ensure every Virginian can access the preventive and primary care they need to stay healthy and thrive.”

The United States stands apart in its underinvestment in primary care, and many practices and CHCs run on small margins with little in reserve. Shared savings generated through value-based care provide valuable revenue that can be reinvested in care delivery, and, in Virginia, this high-quality care led to substantial savings among Anthem’s commercially-insured patients, bringing more than $2 million in shared savings payments back into community primary care.

“Putting our members and consumers at the center of what we do is our priority through partnerships with innovative companies like Aledade,” said Mark Schneider, Regional Vice President Medicare Market Performance. “Together, we can address the health of people and our healthcare system in the right way, improving health outcomes and lowering costs.” 

Value-based care is a system that pays health care clinicians for keeping people healthy rather than just for the volume of services they deliver, with the goal of helping patients stay healthy. Aledade’s model of value-based care centers on proactive and preventive primary care, providing primary care practices, health centers and rural health clinics with the tools and resources they need to care for their communities. This model of care empowers primary care practices and health centers to connect with their patients before they get sick, visit the hospital or go to the emergency room, and embrace and support patients after a medical emergency. Nationwide, Aledade’s model has helped millions of patients get better care, delivered hundreds of millions of dollars back to community primary care, and saved the health care system billions. 

About Aledade

Aledade, a public benefit corporation, is the largest network of independent primary care in the country, helping independent practices, health centers and clinics deliver better care to their patients and thrive in value-based care. Through its proven, scalable model, which includes cutting-edge data analytics, user-friendly guided workflows, health care policy expertise, strong payer relationships and integrated care solutions delivered through Aledade Care Solutions, Aledade empowers physicians to succeed financially by keeping people healthy. Together with more than 1,500 practices and CHCs in 46 states and the District of Columbia, Aledade shares in the risk and reward across more than 150 value-based contracts representing more than two million patient lives under management. To learn more, visit www.aledade.com or follow on X (Twitter), Facebook or LinkedIn.

About Anthem Blue Cross and Blue Shield in Virginia

Anthem Health Plans of Virginia, Inc. trades as Anthem Blue Cross and Blue Shield in Virginia, and its service area is all of Virginia except for the City of Fairfax, the Town of Vienna, and the area east of State Route 123. Anthem Blue Cross and Blue Shield and its affiliate HealthKeepers, Inc. are independent licensees of the Blue Cross Blue Shield Association. ANTHEM is a registered trademark of Elevance Health. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. Additional information about Anthem Blue Cross and Blue Shield in Virginia is available at www.anthem.com. Also, follow us on Twitter at www.twitter.com/anthemBCBS and on Facebook at www.facebook.com/AnthemBlueCrossBlueShield.

For more information:
Jess Gawrych
[email protected]
508-615-6777