Florida Blue, Aledade claim value-based collaboration saved $14 million

Photo: Martin Barraud/Getty Images

Florida Blue, the state's Blue Cross Blue Shield plan, and Aledade, a network of independent primary care providers, have claimed that their collaboration on a value-based care network in the state has resulted in nearly $14 million in shared savings.

The network encompasses nearly 60 primary care practices, federally qualified health centers, rural health clinics and multispecialty clinics.

WHAT'S THE IMPACT?

Results from the Aledade-Florida Blue ACO show the 59 primary care practices that participated in 2022 outperformed the market in rates of control of diabetes, as well as screening rates for breast cancer, colorectal cancer and cervical cancer.

The practices also increased their rates of patient outreach through workflow management, connecting with three out of every four patients following an inpatient visit, the organizations said.

They said about 41,000 patients have been served under the collaboration.

Other results show that between year one and year two, the participating practices reduced hospitalizations by twice as much as other practices in their region (a 15% reduction compared to 7%) and visits to the emergency department (a 1.8% reduction compared to 0.8%).

Florida Blue said the goal of better managing chronic diseases and improving healthcare affordability has been achieved in part by providing necessary claims data and support to Aledade, which then provides participating physicians with a range of capabilities including data analytics, guided workflows, policy expertise and support from local experts in practice transformation.

THE LARGER TREND

The Medicare Shared Savings Program – for which Aledade is the main vendor used by MSSP participants – saved Medicare $1.8 billion in 2022 compared to spending targets for that year, the Centers for Medicare and Medicaid Services said last month.

Of the 482 accountable care organizations in 2022, 84% achieved savings to Medicare and 63% earned shared savings, according to CMS and the National Association of ACOs. MSSP actually saved Medicare $4.3 billion, with the savings of $1.8 billion reported after accounting for shared savings and losses, according to NAACOS.

Shared Savings Program Accountable Care Organizations are groups of doctors, hospitals and other healthcare providers who collaborate and provide coordinated, high-quality care to people with Medicare while avoiding unnecessary services and medical errors.

ACOs have generated more than $21 billion in gross savings for Medicare over the last decade. More than 700,000 physicians and other nonphysicians participate in Medicare ACOs, caring for more than 13 million beneficiaries, making it the largest alternative payment model in Medicare.

Based on the program's success, CMS has set a goal that 100% percent of people with Traditional Medicare will be part of an accountable care relationship by 2030.

ON THE RECORD

"We are deeply grateful to Florida Blue for working with us to empower primary care practices in Florida and bring better primary care to tens of thousands of Florida patients," said Ananya Banerjee, chief commercial officer at Aledade. "Every patient deserves the proven benefits of physician-led value-based care, whether they get their health coverage through traditional Medicare, Medicare Advantage, commercial health plans or Medicaid. Florida Blue's partnership and the structure of their value-based care program, including sustainable benchmarking methodology and regional benchmarking, ensure the true alignment essential to value-based care."
 

Twitter: @JELagasse
Email the writer: Jeff.Lagasse@himssmedia.com