Private Payers News

Wellcare partners with tech company to improve value-based primary care

The partnership will allow Wellcare to share increased financial risk and advance value-based primary care.

value-based primary care, value-based care arrangements, primary care physicians

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By Victoria Bailey

- Wellcare, the Medicare brand of Centene Corporation, has partnered with a technology company to improve access to value-based primary care.

The company, Pearl Health, focuses on physician enablement and risk-bearing in value-based care contracts. The multi-year collaboration with Pearl Heath will benefit Medicare Advantage beneficiaries by creating a pathway that allows the two organizations to share increased financial risk and work together under value-based care models.

Primary care providers in Wellcare’s networks will gain access to Pearl Health’s data insights, financial tools, practice enablement technology, and value-based care services. With these resources, Wellcare and its providers can provide more proactive whole-patient care while improving care quality and reducing costs.

The program is currently live in South Carolina, with hopes that the Wellcare collaboration will help expand it further across the country. The additional support from Pearl Health and Wellcare may help more primary care physicians shift from fee-for-service to value-based care arrangements.

“We are pleased to deploy a value-based partnership with Pearl as we work together to improve quality and clinical outcomes for our diverse and complex Medicare Advantage members,” Michael Carson, Centene’s Medicare chief executive officer, said in the press release. “We look forward to success as we work collaboratively in South Carolina for Medicare Advantage members.”

As the shift to value-based care continues, more healthcare stakeholders are leveraging outside sources and technology vendors to successfully participate in value-based contracts.

For example, CareFirst BlueCross BlueShield partnered with Aledade to help independent primary care physicians access resources needed for value-based care. Through the collaboration, CareFirst physicians can leverage specialists providing onsite business support, healthcare regulatory and policy expertise, and a technology platform that works with more than 100 different EHRs.

Payers can also accelerate value-based care by creating health plans targeting specific populations, such as chronic diseases or disabilities. Aligning value-based care objectives across all stakeholders is critical to ensuring members receive better quality care and lower costs.