Aledade partners with physician practices, health centers and clinics to assist them in building ACOs and other value-based care programs. The start-up is currently aligned with more than 7,300 providers across 26 states, representing 810,000 patients. (Aledade)

Aledade is a winner of FierceHealthcare's Fierce 15 awards. See our other honorees here.

When COVID-19 hit, it hit primary care practices around the country especially hard.

With stay-at-home orders across the country blocking them from seeing patients, most had to pivot to telehealth services. 

For Aledade, a company that partners with physician practices, health centers and clinics to assist them in building ACOs and other value-based care programs, helping primary care practices weather the storm has become a key mission.

The company, which is aligned with more than 7,300 providers across 26 states, representing 810,000 patients, is working to help them see the alternative to fee-for-service care.

"We have to treat primary care special for three reasons. One is, it’s not you saving primary care. It’s primary care saving you, right? They’re the ones on the front lines of COVID early diagnosis and treatment," said Farzad Mostashari, founder and CEO of Aledade.

More than 95% of Aledade’s ACOs have been in operation for three years or more and all have produced shared savings through the Centers for Medicare & Medicaid Services' new Pathways to Success ACO model. Beyond savings, many participating physician practices saw their Medicare Advantage star ratings increase from 3 stars to 4.5 stars in one year.

Fierce Insights with Farzad Mostashari, MD, CEO of Aledade

Farzad Mostashari, MD (Aledade)

What is your best piece of advice for launching a healthcare company that challenges the status quo?

Be clear-eyed about the financial incentives inherent in the business model you choose. You can say, “we’re in this to do prevention,” but if you’re paid based on treatment, your incentives are fundamentally not aligned with what’s good for patients, good for doctors and good for society.

What is the failure you’ve learned the best lesson from?

Our first year in Delaware, in 2015, we did everything right. We reduced hospitalizations and ED visits. We improved the quality of care. We brought in more patients for annual wellness visits and delivered more transitional care management visits when patients left the hospital. But at the end of the year, we didn’t earn a shared savings check. We learned the hard way that this is a long game.

In 2019, our Delaware ACO saved Medicare more than $18 million, which means these primary care practices earned millions in shared savings--revenue that came just as they were fighting COVID-19. Value-based care takes time: you have to commit to being in this for the long run.

What is the book you recommend to other healthcare leaders?

Lately, I’ve been enjoying Dan Heath’s latest book, Upstream. It’s ultimately about how leaders and organizations can take the problems they see and rather than scrambling to fix them immediately, go upstream to stop them where they start. In healthcare, that means not just focusing on coordinated healthcare and better prevention, but also helping to advance a payment system that finally aligns the incentives of our system with coordinated healthcare and better prevention. That’s value-based care.

What is the biggest change to watch for in the healthcare industry in 2021?

I think there will be multiple, successful IPOs of companies focused on taking on the risk of total cost of care. We won’t be one of them, yet, but we’re excited to see other fellow travelers in this space.

In light of the national conversation that is happening right now, what advice would you offer to healthcare leaders seeking to make a real impact on systemic problems of racism?

Don’t be a bystander. For those of us who work in healthcare, the words “I can’t breathe” mean that we must act. We must help. We have to rush in. Therefore, we have to actively reflect and actively listen to our colleagues of color, and the communities of color that we have failed to serve for so long.

What is the biggest lesson your company has gained as a result of responding to COVID-19?

In an emergency, don’t worry about your business; worry about your customers. And do the right thing. For us, that meant pivoting immediately at the start of COVID to secure more than a million dollars’ worth of personal protective equipment for primary care practices in Aledade ACOs. It meant launching hundreds of practices in a single week onto a telehealth platform. And it meant taking time to help guide each practice through the paycheck protection program and other small business loan opportunities. We didn’t do all of this because it was good business, we did it because these primary care practices needed it.