Private Payers News

CareFirst, Aledade Partnership to Help PCPs with Value-Based Care

The player plans to leverage tools and resources provided by Aledade to enhance the quality of care while reducing healthcare costs, supporting value-based care goals.

Source: Getty Images

By Sarai Rodriguez

- CareFirst BlueCross BlueShield (CareFirst) has formed a strategic alliance with Aledade, Inc. (Aledade), offering independent primary care physicians tools and resources to improve healthcare affordability and effectiveness, supporting CareFirst member physicians in achieving value-based care goals.

Through this value-based relationship, CareFirst member physicians can leverage specialists, including onsite business support for physician practices, a technology platform that works with more than 100 different EHRs, and healthcare regulatory and policy expertise.

“When we put clinicians back in charge, patients, practices, and society as a whole see the results,” Farzad Mostashari, MD, co-founder and CEO of Aledade, said in a press release “CareFirst has created a model risk arrangement that creates long-term alignment and sustainability in service to patients and their entire communities. When we can give clinicians the means to keep their patients healthy and out of the hospital, everybody benefits.”

Aledade, a public benefit corporation, helps independent primary care practices with data analytics, care management, and patient outreach tools, facilitating their participation in value-based care arrangements, according to the press release.

CareFirst and Aledade indicated that this partnership will help empower physician-led practices, which have proven to be effective at practicing value-based care, the two groups said.

Research has shown that physician-led practices reduce the rate of avoidable hospitalizations. A 2019 analysis of Medicare data revealed that physician-led accountable care organizations (ACOs) generated on average seven times the amount of cost savings per beneficiary than hospital-led ACOs. In 2019, the study from consulting firm Avalere showed that low-revenue ACOs led by physicians produced $180 in Medicare savings per beneficiary, while high-revenue ACOs led by hospitals or health systems generated only $26 per beneficiary.

“The data clearly shows us that healthier outcomes for patients are directly influenced by the relationship people share with their primary care doctors,” said Brian D. Pieninck, president and CEO of CareFirst. “Partnering with Aledade to bring their services to CareFirst providers is a crucial step toward building a prevention-based, whole-health approach to healthcare.”

“Through this strategic alliance, we look forward to seeing improved health outcomes and lower cost trends, as these are the core principles of value-based care,” continued Pieninck.