Today Regence BlueCross BlueShield of Oregon, Regence BlueShield and Aledade announced a new, multi-year value-based collaboration aimed at delivering better, simpler and more affordable health care for members.
Regence and Aledade will work together to provide tools, resources, coaching and support, and data sharing to rural and independent primary care providers starting January 1, 2021. This relationship will enable more effective care management – including a focus on individuals with chronic conditions – while transitioning these providers from a system of being paid for volume to one where they are paid for better outcomes. At a time when the COVID-19 pandemic has put added strains on primary care and led to increased provider consolidation, this arrangement is tailored to providing additional support for independent physicians across both states.
“Experience tells us that when you combine primary care with a value-based approach, patients benefit with better health at lower costs,” said Dr. Marion Couch, Regence’s senior vice president and chief medical officer. “Partnering with Aledade will enable us to better support our rural and independent provider partners and improve the quality of care for our members across Oregon and Washington.”
At least 40 percent of Regence health plan member claims currently flow through value-based arrangements (VBAs). Results demonstrate significant improvements in care outcomes and savings over more traditional models, including:
- 6 percent lower costs
- 200 percent higher patient satisfaction scores, as judged by net promoter scores (NPS) among members in VBAs vs non-VBA arrangements
- 17 percent higher quality care gaps closed
- 33 percent lower catastrophic spend
- 14 percent fewer opioid scripts filled
Regence’s VBAs tie provider payments to quality versus quantity of care. Over the past seven years, the health plan has paid more than $150 million in total provider payments (including Medicare Advantage) linked to specific quality measures that address gaps in care, encourage clinical best practices, and promote important preventive screenings. More information about Regence’s value-based approach can be found in a recent white paper “Where collaboration meets innovation.”
“We are at a critical moment in health care when many physicians, especially those in rural communities, face significant resource constraints and financial challenges,” said Mat Kendall, president of Aledade. “Aledade’s work with Regence and our collaborative effort to support these physicians with the tools, guidance, and support to deliver the benefits of value-based care will both improve the lives of patients and strengthen the vitality of these anchors of primary care in their local communities.”
Aledade’s Accountable Care Organization (ACO) network covers more than 810,000 patients across 46 ACOs in 26 states with more than 500 participating practices. In 2019, Aledade’s commercial contracts helped bring in more than $16 million in shared savings payments to more than 230 small, independent primary care practices across 15 states. In Medicare, real-world improvements in patient care among the nearly 5,000 independent physicians practicing in Aledade’s Medicare Shared Savings Program ACOs include:
- Reducing patient stays in hospitals by an average of nine percent, and avoiding more than 10,000 hospitalizations in 2019
- Increasing primary care services by 7.5 percent between 2018 and 2019 in Aledade Medicare ACOs, leading to 90,000 more visits between patients and their primary care physician
- Improving blood pressure screenings, A1C control, and rates of cancer screenings
Regence is committed to supporting health care professionals during the COVID-19 pandemic. Steps taken include expanding virtual care access, expediting provider payments and credentialing to help meet emerging demands, advocating for providers to receive additional federal aid, and supporting discharge so patients can be quickly moved to alternate settings to accommodate critical COVID-19 patients.
Regence serves more than 3.3 million people through its Regence health plans in Idaho, Oregon, Utah and Washington. Each Regence health plan is a nonprofit independent licensee of the Blue Cross and Blue Shield Association. Regence is part of a family of companies dedicated to transforming health care by delivering innovative products and services that change the way consumers nationwide experience health care. For more information, please visit regence.com.
Founded in 2014, Aledade partners with independent practices, health centers, and clinics to build and lead Accountable Care Organizations (ACOs) anchored in primary care. Through these ACOs, Aledade empowers physicians to stay independent, practice medicine like they’ve always wanted to, and thrive financially by keeping people healthy. Aledade offers a comprehensive range of capabilities that includes cutting-edge data analytics, user-friendly guided workflows, unparalleled regulatory expertise, strong payer relationships, and local, hands-on support from attentive experts. In true alignment with more than 7,300 participating providers in 26 states, Aledade shares in the risk and reward across over 76 value-based government and commercial contracts representing more than 810,000 lives under management. To learn more, visit www.aledade.com or follow on Twitter or LinkedIn.