Value-based healthcare with two-sided risk led to a savings of about $14 million over two years, according to the Florida-based insurance plan and national primary care provider company that oversee the system.
Florida Blue and Aledade, the largest network of independent primary care providers in the country, embed their value-based approach to care delivery in accountable care organizations that serve more than 41,000 patients.
“Results from the Aledade-Florida Blue ACO show the 59 primary care practices that participated in 2022 outperformed the market in rates of control of diabetes, as well as screening rates for breast cancer, colorectal cancer and cervical cancer,” according to a joint press release. “The practices also increased their rates of patient outreach through workflow management powered by the Aledade App, connecting with 3 out of every 4 patients following an inpatient visit.”
Hospitalizations also decreased between the first and second years of the program by twice as much as other practices in the state, a 15% reduction compared to 7%. Emergency department visits followed the same trend, with the Aledade-Florida Blue ACOs seeing a 1.8% reduction compared to 0.8%.
Phil Lee, Florida Blue’s vice president of strategic provider partnerships, said in the press release that “this collaboration demonstrates the importance of partnering to address overall health and well-being while improving the experience for providers and patients, driving better outcomes, and lowering costs.”
Ananya Banerjee, Aledade’s chief commercial officer, said in the press release that “every patient deserves the proven benefits of physician-led value-based care, whether they get their health coverage through traditional Medicare, Medicare Advantage, commercial health plans or Medicaid. Florida Blue’s partnership and the structure of their value-based care program, including sustainable benchmarking methodology and regional benchmarking, ensure the true alignment essential to value-based care.”
Aledade, a public benefit corporation, has been on a roll this year. In its June earnings report, the company announced that it had picked up more than $380 million in venture capital money in the previous 12 months to fuel its continued growth. Bloomberg reported at the time that the funding deal placed the company’s value at $3.5 billion.
In addition, last month the Centers for Medicare & Medicaid Services (CMS) reported that the Medicare Shared Savings Program, for which Aledade is the vendor, has saved a net $1.8 billion in 2022 for ACOs, which is the second-highest annual savings since the program began 10 years ago. CMS Administrator Chiquita Brooks-LaSure said “it is exciting to see that accountable care organizations are continuing to be successful in delivering coordinated, high-quality, affordable, equitable, person-centered care.”
Florida Blue has been busy this year as well, commissioning a survey to find out what might keep uninsured individuals from signing up for health coverage and to figure out ways to encourage them to do so.
Florida Blue CEO Pat Geraghty said at the time that “we realize that people are busy, tired, and everything costs more, but we are here to help them during these challenging times and make it easier than ever to switch plans or sign up for plans.”
Last month, the insurer announced that through its Florida Blue Foundation it was donating $400,000 to the Boys & Girls Clubs of America to help those organizations better implement behavioral health practices.