Aledade, Highmark Blue Cross Blue Shield Expand Value-Based Health Care in Delaware and West Virginia
Bethesda, Md. – Aledade, Inc. and Highmark Blue Cross Blue Shield today announced a new agreement to bring high quality, affordable health care to patients in Delaware and West Virginia. Aledade’s physician-led Accountable Care Organization (ACO) in both states will expand to provide value-based care for patients covered by Highmark plans. Approximately 40,000 Highmark plan members will benefit from Aledade ACO practices’ high-quality, coordinated care.
The Aledade Delaware ACO and Aledade West Virginia ACO include 22 and 26 independent primary care practices and Federally Qualified Health Centers (FQHCs) respectively, in total caring for more than 50,000 Medicare patients through the Medicare Shared Savings Program. These practices will be accountable for the total health care experience of Highmark members attributed to their practices.
“This is an exciting opportunity for our West Virginia and Delaware ACOs, and yet another sign of the shift to value over volume being embraced by commercial payers across the country,” said Dr. Farzad Mostashari, CEO and co-founder of Aledade. “Through this partnership, independent physicians can take advantage of Aledade’s model and resources to deliver better health outcomes and lower costs to Highmark members.”
Aledade offers a new model of primary care by partnering with physicians to build and lead ACOs – networks of physicians who band together to deliver coordinated care to patients. Aledade operates under a value-based payment structure that rewards positive health outcomes for patients, instead of the volume of health care services delivered. While this work started under a Medicare model, new partnerships with private payers like Highmark signal an important transition. Our partnership with Highmark represents a shared savings program with a goal of moving to more advanced reimbursement models in years to come.
“Highmark is excited to develop an accountable care relationship with Aledade and its integrated network of independent primary care physicians in Delaware and West Virginia,” said Tom Fitzpatrick, senior vice president of provider contracting and relations at Highmark Blue Cross Blue Shield. “Our goal with these relationships is to ensure members receive high quality, cost effective care while improving care coordination through physician-led care delivery transformation.”
A leader in the Pennsylvania, Delaware and West Virginia health care industry, Highmark will provide the ACO with expertise and experience in care management and quality improvement, as well as comprehensive patient care data. This gives physicians the ability to see beyond the walls of their practice for a comprehensive view of their patients’ health. Through this agreement, Aledade and Highmark will strive to create value in health care by improving quality and reducing health care costs.
Aledade’s partnership with Highmark also represents an opportunity for regional physicians by providing primary care physicians with unparalleled regulatory expertise; best practices from a national network of primary care doctors; user-friendly technology and data analytics that provide insight into the full spectrum of care patients receive; and face-to-face practice transformation support.
“Aledade believes primary care is the foundation of an effective health care system, and we’re excited for our independent physician partners in Delaware and West Virginia to be at the forefront of scaling high-quality care across multiple patient populations and insurers. In our ACOs, physicians can remain independent, but share in the upside of reducing health care costs while never losing sight of the foundational goal to provide quality care to their patients,” said Ahmed Haque, vice president of provider networks for Aledade’s Mid-Atlantic region.
Since its founding in 2014, Aledade has grown significantly, partnering with 200 practices across 15 states and representing 240,000 covered lives and nearly $2 billion in health care spending. In addition to this growth, Aledade has improved the quality of care for the individuals covered by Aledade’s practices. In 2015, Aledade ACOs increased preventive care visits by an average of 251 percent and increased transitional care services by an average of 175 percent, and saw a decrease in emergency department visits, hospital utilization, and hospital readmission rates. At the same time, Aledade ACOs supported small practices with a $51,000 average increase in practice revenue.
Founded in 2014, Aledade offers a new model of primary care that puts physicians back where they should be: quarterbacking their patients’ health care. Aledade partners with primary care physicians to build and lead Accountable Care Organizations (ACOs) that allow these doctors to stay independent, practice medicine like they’ve always wanted to, and thrive financially by keeping people healthy. Aledade provides data analytics and user-friendly technology to help doctors provide more seamless care, unparalleled regulatory expertise, the best practices shared by a national network of hundreds of doctors, and face-to-face practice transformation support. Based in Bethesda, Md., Aledade is led by CEO and Co-founder Dr. Farzad Mostashari, former National Coordinator for Health Information Technology at the U.S. Department of Health and Human Services. Since its founding in 2014, Aledade has established successful organizations in New York, Delaware, Maryland, Arkansas, West Virginia, Tennessee, Mississippi, Florida, Louisiana, Virginia, Kansas, Michigan, Utah, Missouri, and Pennsylvania that care for more than 200,000 patients.
At the heart of the Aledade model is the simple, but radical, idea that Aledade only succeeds when partner practices succeed in delivering better care at a lower cost. For more information, visit aledade.com. Aledade is a registered trademark of Aledade, Inc.
About Highmark Inc.
Highmark Inc. and its health insurance subsidiaries and affiliates collectively are among the ten largest health insurers in the United States and comprise the fourth-largest Blue Cross and Blue Shield-affiliated organization. Highmark and its diversified businesses and affiliates operate health insurance plans in Pennsylvania, Delaware and West Virginia that serve 5.2 million members and hundreds of thousands of additional members through the Blue Card program. Its diversified businesses serve group customer and individual needs across the United States through dental insurance, vision care and other related businesses. Highmark is an independent licensee of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield companies. For more information, visit www.highmark.com.
FOR IMMEDIATE RELEASE
December 19, 2016
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