With an estimated 65 million Americans covered under value-based care plans by 2025, payers are making big investments in care delivery models that focus on quality over quantity. From partnerships with providers to billion-dollar purchases of home care services, these are eight recent payer investments in value-based care:
United Physicians and Austin, Texas-based Agilon Health entered a long-term partnership May 3 to transition United's primary care delivery system for Medicare Advantage patients to a full-risk value-based care model.
BCBS of Michigan, physician services group team up on Medicare value-based contracts
Blue Cross Blue Shield of Michigan partnered with Nashville, Tenn.-based Honest Medical Group on April 25 for a venture they say will ease physicians' transition to value-based care for Medicare and Medicare Advantage patients. Transitions often require significant resources to add or upgrade EHRs, billing systems, virtual care and other practice capabilities, so Honest Medical Group will provide the financial and human resources backing to assist practices during the transformation.
Priority Health, Accolade partner to offer members custom value-based health plans
Priority Health partnered with Seattle-based Accolade April 13 to offer custom and value-based policies to Michigan members. Priority members will be offered a support model using virtual care services and personalized navigation capabilities.
CalOptima invests record $50M in value-based care for California health centers
CalOptima said April 13 it is investing a record $50 million over the next five years into 26 community health centers in Orange County, Calif. The Medi-Cal plan awarded the grant to the Coalition of Orange County Community Health Centers to improve value-based care access, outcomes and the safety-net system.
UnitedHealth to buy home-health firm LHC Group
UnitedHealth Group's Optum agreed to buy Lafayette, La.-based home-health firm LHC on March 29. The agreement will allow members to receive value-based care in the comfort of their homes. LHC employs about 30,000 people across 37 states and cares for more than 500,000 patients annually. The deal is for about $5.4 billion and is expected to close in the second half of 2022.
Clarify Health acquires Embedded Healthcare to grow value-based payment plans
San Francisco-based software firm Clarify Health acquired Washington, D.C.-based Embedded Healthcare March 14. Clarify is an analytics platform that provides custom patient care plans. Embedded Healthcare uses behavioral science to assist payers with new payment models and incentivize lower care costs through providers. The merger between the two companies aims to improve collaboration between providers and payers to scale the adoption of value-based payment models.
CommonSpirit launching outcome-based healthcare model in 6 underserved communities
CommonSpirit Health said in March it is partnering with the Pathways Community HUB Institute to implement a community-centric care navigation model in six states. The model is designed to allow health systems, payers, public entities and community organizations to identify and reach out to those "greatest at risk" and connect them to social, medical and behavioral interventions and services in their community. Once connected with services, the model can track outcomes and contract with payers to directly tie payment to those outcomes. Organizational work has begun, and a full launch of the program is expected this winter.
MaineHealth, Agilon Health partner to improve primary care for Medicare Advantage patients
Austin, Texas-based Agilon Health began implementing a long-term partnership with MaineHealth to improve primary care services March 11. Agilon assists providers with transitioning to value-based care models. The partnership will create a new value-based primary care delivery model to improve care outcomes for Medicare Advantage beneficiaries across Portland-based MaineHealth.