Amerigroup Creates Risk-Based Partnerships for Medicare Advantage
Amerigroup is enhancing Medicare Advantage care quality through risk-based partnerships with two Texas health systems.
Source: Thinkstock
By - Amerigroup has announced two risk-based partnerships between health systems in Houston and El Paso that aim to enhance quality of care and increase provider access for Medicare Advantage (MA) beneficiaries.
Renaissance Physicians Organization (RPO) in Houston and El Paso Integral Care enter the risk-based agreements on August 1st. Providers will be held accountable for delivering long-term preventative and collaborative care of MA patients.
Both Amerigroup and the health systems see the agreements as a way to proactively drive value-based, high quality care for vulnerable MA patient populations.
“Amerigroup and El Paso Integral Care share the same goal of delivering high-quality affordable health are to the members we are privileged to serve,” said Josh Martin, president of Amerigroup Medicare west region.
“Cost of care continues to be an important issue for seniors living on a fixed income, particularly with more than half of the dual eligible population living on $10,000 a year or less. By continuing to add clinicians with excellent reputations for quality, our goal is to help our members manage their care, improve their health outcomes, and lower their costs.”
“Amerigroup and RPO share the same goal of delivering high-quality affordable healthcare to the members we are privileged to serve,” Martin added.
The agreements for both health systems include enhanced care for beneficiaries under Amerivantage Select and Amerivantage Dual Coordination. These are health plans available to individuals who are eligible for Medicare and/or Medicaid. The plans provide extra benefits not available with traditional Medicare.
Amerivantage Select, an HMO, offers $0 premiums - but requires consumers to pay certain out-of-pocket costs. Other Amerivantage benefits include $0 copay for primary care visits, as well as no copays for preventive care services including annual physical, dental vision and hearing exams.
Amerivantage Dual Coordination, an HMO SNP, has a $0 premium for individuals with Medicare and qualified Medicaid. Dual Coordination also offers a $0 copay for routine foot care, free transportation for medical and pharmacy visits, and up to $2,500 per year toward the purchase of dental services.
Payer-provider collaboration is critical when attempting to extended care networks that promote successful risk agreements.
“Health payers can play a role in improving education and awareness,” stated Mitch Morris, Principal and healthcare industry leader at Deloitte. “Many physicians, especially the ones in smaller independent practices, don’t have a good understanding of what it means to manage clinical and financial risk. Health plans can help them do that certainly when there are financial incentives.”
“This collaboration between our organizations reinforces our commitment to delivering high-quality care, while allowing our members to live the life they’ve earned,” Martrin said.
Leaders at each health system believe that Amerigroup is a payer that can drive these risk-based agreements into deliverable improvements of MA care quality.
“For more than a decade, Renaissance Physicians has provided high-quality, innovative care within a changing health care landscape by focusing on what matters the most, the patient,” said Dr. John E. Bertini, Jr., chairman of Renaissance Physicians Organization. “The Amerigroup name is a familiar one that represents stability and strength, and Amerigroup’s Medicare plans give people eligible for Medicare another strong option in the Houston area.”
“El Paso Integral Care has one of the largest geographic reaches in the El Paso area through our network of more than 100 physicians and supporting clinicians,” added Dr. Hector Lopez, chairman of El Paso Integral Care. “We are honored that Amerigroup has selected our clinicians to provide healthcare to its members as this helps us achieve our mission – to be a valued member of the community that provides patient care excellence by lessening common health ailments, providing compassionate care, and restoring health and vitality.”
