CareFirst BlueCross BlueShield has tapped Aledade to help its in-network primary care practices better offer value-based care.
Physician-led accountable care organizations deliver better and less costly care than hospital-led ACOs, executives at CareFirst, the largest health plan in the mid-Atlantic region, and Aledade said in an announcement. As part of the "strategic alliance," CareFirst's member physicians will have access to Aledade's on-site business supports, technology platform and expertise in healthcare policy and regulatory topics.
Brian Pieninck, president and CEO of CareFirst, said in the press release that “the data clearly shows us that healthier outcomes for patients are directly influenced by the relationship people share with their primary care doctors. Partnering with Aledade to bring their services to CareFirst providers is a crucial step toward building a prevention-based, whole-health approach to healthcare.”
Aledade co-founder and CEO Farzad Mostashari, M.D., said in the press release that “when we put clinicians back in charge, patients, practices, and society as a whole see the result. CareFirst has created a model risk arrangement that creates long-term alignment and sustainability in service to patients and their entire communities. When we can give clinicians the means to keep their patients healthy and out of the hospital, everybody benefits.”
The companies cited a 2019 study by healthcare consultancy Avalere that showed physician-led ACOs outperform hospital ACOs when it came to delivering care for Medicare beneficiaries, producing almost seven times the savings per beneficiary. Avalere's analysis found that physician-led ACOs have a stronger incentive to keep patients out of the hospital.
Aledade said utilizing preventive care has helped it save more than $1.2 billion across the healthcare systems it partners with, mostly by preventing hospitalizations and emergency department visits.
Pieninck said that “through this strategic alliance, we look forward to seeing improved health outcomes and lower cost trends, as these are the core principles of value-based care.”
The deal with CareFirst is the only the latest move by Aledade to solidify its unique position in the healthcare sector. The announcement follows on the heels of a deal reached by Aledade and Humana earlier this month. Humana and Aledade’s partnership dates back to 2019 in several states, resulting in 5% fewer hospitalizations and 12% fewer readmissions.
In February, Aledade bought value-based analytics company Curia to further improve its technological capabilities while adding another 450 physician practices to its stable. At the time of the merger, Aledade executives said the Curia acquisition will allow the company to better interpret information from different databases, use AI algorithms to make primary care work flow more smoothly and mine historic data to help predict future trends.
Last June, Aledade received $123 million in fundraising through a series E round. The company says it partners with 1,500 practices in 45 states and the District of Columbia covering more than 2 million patients. Aledada’s nearly 150 contracts with physician practices hinges on two-sided value-based risk, in which Aledada shares in the savings but also must pay up if things go the other way.