USA — Insurer Humana and independent primary care network Aledade have agreed on a decade-long partnership to deliver value-based care to Humana’s Medicare Advantage members.
Aledade’s physicians will offer primary care to Humana members using value-based arrangements, and the partnership will extend as new practices and markets are integrated into Aledade’s network.
Aledade partners with independent primary care practices across 45 US states, with over 65% of its practices located in federally designated areas lacking primary care professionals.
Its network comprises more than 5,000 physicians and 15,000 clinicians operating under value-based payment arrangements.
Aledade will track the success of its partnerships through three key metrics: increased utilization of primary care services, decreased emergency department visits, and reduced hospitalizations.
Aledade’s partnership with Humana is significant in the US healthcare landscape as it represents a shift towards value-based care.
The new 10-year collaboration will see the partners phase in current and new state-wide agreements for value-based care for Humana’s Medicare Advantage members.
This shift towards value-based care and the transfer of financial risk from payers to providers is a significant trend in the US healthcare landscape, as it aims to improve patient outcomes while reducing costs.
The partnership’s agreements include a pathway to full risk, meaning that Humana will transfer all financial risk to Aledade.
According to an announcement, the partnership between Aledade and Humana has been ongoing for since 2019, with more than 100,000 Humana members being treated by Aledade physicians by the end of 2022.
In the time since their initial collaboration in 2019, the two companies have successfully reduced inpatient hospitalizations by 5% and readmissions by 12%.
The newly established partnership builds on this work and includes a pathway to full risk. As Aledade’s national network expands to include additional practices and markets, the two organizations will phase in current agreements as well as new statewide collaborations.
Both Aledade and Humana share a commitment to value-based care, which emphasizes personalized care tailored to each patient’s unique health needs and more time spent with patients, according to Humana’s President of Medicare and Medicaid, George Renaudin.
The partnership between Walmart and UnitedHealth Group is also an example of the rise of value-based care partnerships in the U.S. healthcare landscape.
The 10-year collaboration will focus on driving adoption of value-based care for Walmart’s clinicians, launching a new Medicare Advantage plan, and expanding into new regions.
The companies aim to reach hundreds of thousands of Medicare Advantage members through the partnership, with UnitedHealth’s Optum providing data analytics and decision support tools to enhance the care provided at Walmart Health centers.
The partnership will also offer the UnitedHealthcare Medicare Advantage Walmart Flex plan, available for the 2023 plan year in Georgia, with plans to expand to reach Medicaid members and people in commercial plans in the future.
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