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Delaware primary care docs take on value-based contracts with Aetna

Nicholas Ciolino
Beshara Helou, MD of Georgetown Medical Associates

Some Delaware primary care practices are taking on more contracts that pay for positive patient outcomes rather than for the number of tests and services.

The 23 practices are part of the Accountable Care Organization Aledade. The group announced Tuesday it is taking on value-based care contracts with the insurance company Aetna.

Value-based care pays physicians for healthy patient outcomes rather than for the number of tests they perform. Through this payment model, Aledade’s Delaware practices were able to save Medicare more than $5.5 million in 2017.

Aledade CAO Sean Cavanaugh says Aetna patients will now receive the same preventive services, follow up care and population health management as do Aledade’s Medicare patients.    

“Our Aledade doctors in Delaware will be monitoring, for example, when their Aetna patients are discharged from the hospital,” said Cavanaugh. “They’ll get real time notifications and they’ll be reaching out to them to help them with the transition back to the community—help them manage their medications which can often be confusing when you’re leaving the hospital.”

Cavanaugh also says he thinks value-based contracts will eventually help to improve access to primary care in Delaware, because physicians will be able to share in the cost savings the contracts create.

“If these value-based contracts are successful as they have been, one: primary care doctors will be practicing in a way they’ve always wanted to practice so the work will be more meaningful to them, and two: to the degree they’re successful and get additional payments it will be a better paying specialty,” he said.

Aledade already has value-based contracts with Highmark Blue Cross Blue Shield Delaware.

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