Payers invested in value-based care throughout 2022, teaming up with Walmart and many other companies to prioritize quality-based payments.
Around 4 in 10 health plans use alternative payment models, a survey from the Healthcare Payment Learning and Action Network found, with these models most common among Medicare Advantage plans.
These are 10 partnerships Becker's reported this year to know:
- Aetna is partnering with Crossover Health to bring in-person and virtual value-based primary care to employer-sponsored health plans in the Seattle area. The pilot program, Aetna Advance Primary Health, will be available to self-insured employers and businesses with more than 51 employees beginning in 2023.
- Aetna inked a value-based contract with in-home care provider Amedisys. Former Amedisys CEO Chris Gerard said the company has similar value-based contracts in the works with other payers during an October investor call.
- Humana is adding value-based kidney care from in-home provider Monogram Health, the payer said in October. In-home care visits, medication management and dialysis and transplant coordination will be available to Medicare Advantage members in Tennessee, Alabama, Mississippi and Louisiana.
- Independence Blue Cross and Penn Medicine are partnering on a value-based primary care model centered around co-ownership of Blue Cross' physician network subsidiary, Tandigm. In September, the payer said it would sell a minority equity stake in Tandigm to the Philadelphia health system for an undisclosed amount to allow more patients continued access to their PCPs and new pathways to Penn's specialty services.
- UnitedHealth Group and Walmart are partnering around a value-based care model for Medicare Advantage members and a co-branded health plan. The 10-year collaboration will begin in 2023 at 15 Walmart Health centers in Florida and Georgia, which will be enabled by Optum's analytics and decision support tools, the company said in September.
- Priority Health is partnering with rural care startup Homeward to bring in-home and mobile care to Medicare Advantage members across Michigan. San Francisco-based Homeward, which clinched $50 million in series B funding Aug. 3, has an integrated care model that consists of mobile, community-based care.
- Elevance Health is partnering with Aledade to assist independent primary care physicians transition to value-based care. Aledade is a consulting company that helps primary care practices create accountable care organizations.
- Humana and New York City-based investment firm Welsh, Carson, Anderson & Stowe have established a second joint venture to build more value-based primary care clinics for Medicare patients. The partnership will invest $1.2 billion to develop approximately 100 new clinics between 2023 and 2025 and operate them to profitability.
- Blue Cross Blue Shield of Michigan is partnering with Nashville, Tenn.-based Honest Medical Group for a venture they say will ease physicians' transition to value-based care for Medicare and Medicare Advantage patients. These transitions often require significant resources to add or upgrade EHRs, billing systems, virtual care and other practice capabilities, the payer said.
- Priority Health is partnering with Seattle-based Accolade to offer custom and value-based policies to Michigan employers. The partnership will allow Grand Rapids, Mich.-based Priority Health and Accolade to offer Priority members a support model using virtual care services and personalized navigation capabilities.