Q: How has Equality Health incorporated value-based care into its model?
By distilling down the health plan contract performance elements combined with actionable information to put in the primary care practices hands to deliver high quality, efficient care. Our CareEmpower® platform is a multi-payer population health tool so administrative burden is reduced for the primary care office.
Q: Has the Equality Health team seen improvements in the care experience for patients or a reduction in per capita costs?
Yes, both. Quality as measured by prevention metrics, disease management metrics and avoidable acute care events has improved year over year. Combined, total health care costs for the population have been reduced while delivering more appropriate ambulatory care visits.
"The philosophy of Family Medicine embraces whole-person care that extends to the family and community."
Mark R. Stephan, MD, MBA
Chief Medical Officer
Q: Do you believe value-based care is leading to greater consolidation of primary and specialty care practices with provider network organizations like Equality Health?
It certainly reduces administrative burden for the health plan to consolidate value-based agreements with many, particularly smaller, practices. For practices, tying your raft to a risk-bearing entity like Equality Health allows you to participate in more advanced value-based contracts that previously were unavailable to you based on the size of the patient panel.
Q: Adopting a value-based care model requires a financial risk, especially at the earliest stages of implementation. What were some of the financial burdens Equality Health faced as it moved towards value-based care reimbursements?
We pay incentives proactively (quarterly) to PCPs in advance of any contract performance earnings; thus, we take risk on day one of the performance period.We do this because we understand that the practices need reliable revenue to do the additional work required to be successful in a value-based care.
Q: You are a Family Practice physician. How does a value-based care model impact you and your specialty?
The philosophy of Family Medicine embraces whole-person care that extends to the family and community.In this sense, family doctors, like other primary care providers believe that social determinants of health and equitable access to high quality care for all impacts the health outcomes for individuals and populations.The challenge is that a typical family practice does not have the resources required to meaningfully address all the needs of the patient and family.That is why Equality Health has committed to supporting the independent practices with free technology, education, staff training, and wrap around care coordination and in home services to support their patients they care for.