Florida Blue partners with Sanitas to run a value-based primary care center in Jacksonville

When Florida Blue announced this week that it’s partnering with Sanitas Medical Center in Jacksonville to deliver primary care, officials with the company considered it in keeping with a healthcare system that’s evolving from one based on volume to one based on value.

“The healthcare system has largely been fee-for-service,” Elana Schrader, M.D., senior vice president of Florida Blue healthcare services and president of sister company GuideWell Health, told Fierce Healthcare. “Now, we’re talking about paying for services that help us achieve better outcomes. It’s a whole new value equation. Value-based care has been around, but it’s growing and growing.”

She added that in the future the health plan hopes that most, if not all, of the care provided will be based on value not volume. The umbrella of what can be described as primary care at the Jacksonville center is a large one under which resides, according to a press release, “preventive and primary care, onsite pharmacy dispensing, chronic condition management, mental health services, labs and imaging, and a community use space for patient and community education and social engagement and wellness classes and activities.”

As of now, the physicians at the center will not be taking on two-sided risk, but it could eventually come to that, said Schrader. “That would be in the future,” Schrader said. “But the model of the clinic is fully based on the tenets of creating value.”

Elana Schrader, M.D. (Florida Blue | Sanitas Medical Center)

The clinic will service individuals 50 and older and Medicare enrollees of all ages. Sanitas and Florida Blue have been collaborating since 2015. Florida Blue felt that Sanitas would be a good partner in dealing with changes brought about by the Affordable Care Act.

“We realized that we needed to expand our services to accommodate a big influx of members and patients who were people that we hadn’t really served that much before,” said Schrader. “We wanted to be culturally competent, and culturally expert in taking care of them.”

The Sanitas Medical Center is the 53rd collaborative effort by the two companies across the state, most of which focus on primary care. The Jacksonville center represents their first foray into northeast Florida.

“We’re looking at about 5 million Medicare eligible people across the state of Florida,” Schrader said. “We found that people who are aging into Medicare and people around 50 are really looking for a clinic focused on people their age. Older people are getting more and more vibrant and living longer lives. We really believe that the best way to approach the Medicare eligible population is by introducing ourselves early and taking care of them throughout that cycle.”

In addition to physicians, individuals getting primary care at the Jacksonville center have access to nurses who specialize in different conditions such as diabetes and high blood pressure.

Clinical and nonclinical employees at the center will keep in mind what Schrader called the five Cs: customize, comprehensive, caregiving, convenience and compassionate.

  • Customize: “Our company has sort of woven itself into the community over the course of many, many years here in Jacksonville. We want to be hyperlocal.”
  • Comprehensive: “We help with physical needs, mental health needs and social services as well.”
  • Caregiving: “When I see a 50-year-old coming in, I sometimes close my eyes and picture them coming in with their 75-year-old parent. So many in their 40s and 50s are taking care of their parents, and they need support as well.”
  • Convenience: “The center will be open extra hours, and people will have the ability to access virtual services.”
  • Compassionate: “We have a care team that is assigned to every single patient who comes in. And that team is consistent for that patient or member over time.”

Systemic problems with mental healthcare became much more noticeable and exacerbated because of the COVID-19 pandemic.

“We definitely have a shortage of behavioral health providers,” Schrader said. “One of the things that we’ve done across all of our clinics is build a really comprehensive behavioral health set of services. So, patients have psychiatrists who actually see the patients in the primary care office. Or they’re immediately available through virtual care services. Behavioral health care is pretty much available 24/7 in our Sanitas services. And it’s very, very specific. It’s meant to be holistic, focusing on physical and mental health needs as well as support services.”