Medicaid provider, Christiana Care sign value-based payment agreement

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Christiana Care Health System and AmeriHealth Caritas Delaware entered into a value-based payment agreement, covering Medicaid beneficiaries.

The agreement creates greater flexibility for Christiana Care to address both medical and non-medical health care needs of Medicaid patients. It is designed to fully align the health care payment model with the delivery of high quality, valuable care to Medicaid beneficiaries, a release stated.

Under the new structure, there are benefits for the partnering organizations if health care quality and cost-reduction targets are met or exceeded, and revenue is lower if those targets are not met.

“We are transforming the health system to achieve better health at lower costs,” said Janice E. Nevin, M.D., CEO of Christiana Care. “This value-based care agreement is an incredibly important step that empowers our caregivers to focus on providing the right care, at the right place and time for our Medicaid beneficiaries. It enhances our ability to innovate in meeting the non-medical needs of our patients — addressing challenges such as poverty, hunger and housing insecurity that prevent them from achieving their health goals. We are proud to partner with AmeriHealth Caritas Delaware in this bold new step.”

“This agreement with Christiana Care exemplifies our commitment to providing high-quality health care for our members,” said Emmilyn Lawson, AmeriHealth Caritas Delaware Market president. “It also represents an opportunity to strengthen our relationship with a valued health care provider as our organizations continue the work to help members address the social, economic and environmental barriers to obtaining and maintaining good health.”

An innovative feature of the payment model is that it enhances Christiana Care’s ability to explore health interventions that impact a patient that might not have been covered under a fee-for-service model. Examples may include:

  • Partnering with housing agencies to support transitional housing for homeless patients with complex chronic conditions. Housing allows for improved ability to consistently treat their chronic conditions and support health.
  • Providing nutritious food to chronically ill patients who live in neighborhoods without access to supermarkets or other sources of fresh fruits and vegetables. Adequate nutrition is a foundational aspect of good health.

Through this partnership, Christiana Care receives a pre-determined payment for the cost of providing health care services to the assigned AmeriHealth Caritas Delaware Medicaid members, ranging from wellness screenings to primary care visits to hospital stays. If the health outcome targets for the population are achieved at costs that are lower than standard market value, then Christiana Care and AmeriHealth Caritas Delaware are both able to retain some of those savings

. If the health outcome metrics and cost reductions are not achieved, then Christiana Care would receive less reimbursement than it would have in a traditional fee-for-service payment model, a release noted.

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