Wellvana, a value-based care enabler, is joining forces with AdventHealth as an exclusive partner to its primary care network in Florida.
Advent is transitioning its entire primary care network in the state to value-based care for Medicare and Medicare Advantage patients. The partners’ goal is to improve clinical outcomes and lower the total cost of care. Executives told Fierce Healthcare this will be a long-term partnership, ramping up implementation now for a go-live in January 2024.
“AdventHealth and Wellvana share a vision of redesigning primary care so that it offers a more balanced approach to health, driven not just by sick care, but also wellness and prevention. That starts with integrated, accessible and affordable primary care,” Bryan Stiltz, CEO of AdventHealth’s primary care network, said in an announcement. “Wellvana has the skilled team, actionable technology and customized delivery model to help us provide whole person care to more people.”
From Day 1, 10% of Advent providers will be moving into full-risk, executives told Fierce Healthcare. Others will be transitioning over a period of several years. Wellvana claims to be the first to partner with a multistate health system.
With an emphasis on flexibility, Wellvana aims to empower primary care docs to focus on high-quality preventive care as they transition from fee-for-service to full-risk contracts. It argues its appeal is providing capital upfront as well as staff and tech support designed to streamline the transition.
“AdventHealth’s culture is steeped in integrity and relentless stewardship, which aligns to Wellvana’s core values and high-touch, on-the ground approach to help high-performing physicians,” Kyle Wailes, CEO of Wellvana, said in a press release.
Operating what Wailes calls a high-touch model, Wellvana will provide remote and in-person clinical support teams consisting of care coordinators, pharmacists, social workers and more to AdventHealth’s primary care clinics. Its goal is to increase patient access to healthcare workers, provide timely scheduling and care coordination and continuous education and support on HEDIS (Healthcare Effectiveness Data and Information Set), quality, risk adjustment and other key benchmarks.
On top of that, Wellvana ingests diverse data that its risk models interpret, identifying patients who need to be engaged. “The key foundation for value-based care starts with data,” Wailes told Fierce Healthcare.
The company pulls from EHRs, statewide health information exchanges and specialty EHRs as well as discharge notifications from hospitals, payer claims data, lab and pharmacy data and social determinants of health data, per Wailes. The information is then pushed to providers at the point of care.
PCPs are often seen as the gateway to the system overall, driving referrals and revenue to hospitals. But one survey that Wellvana cites on its webpage found (PDF) that two-thirds of hospital executives see their organization’s ability to manage variation in cost of care at the physician level as “average” or “below average.” A recent study separately found newly integrated primary care physicians “steer” their patients toward a health system’s services, increasing both utilization and care spending.
Value-based care turns those trends around, Wailes argues.
“Primary care can become a profit center for a system overall,” Wailes said, “because the opportunity to impact the total cost and earn a percentage of the shared savings from that is much bigger than what you can earn from primary care alone.”
It is also better for care and outcomes. “It's the right thing to do for the patient,” Wailes added.
Wellvana’s aggregation of data serves as the foundation of its practice scorecard for providers. It also has a field team on the ground at clinics helping providers understand how they’re performing across key performance indicators. It helps show them what that means for savings, for them and the entire health system.
The startup serves hundreds of thousands of Medicare and commercial lives through multiple payers. Its participation in CMS Innovation Center ACO REACH and MSSP models as well as Medicare Advantage offers several paths to risk for every physician in its network.
Wellvana competes with a growing number of players in the value-based care enablement space, from Aledade to Agilon, Privia Health and Vytalize.