Aledade made a bold claim last week: that its value-based care network has helped save the U.S. healthcare system save more than $1.2 billion over the past eight years.
Bethesda, Maryland-based Aledade partners with more than 1,000 independent primary care practices, including more than 140 federally-qualified health centers, across 36 states and Washington, D.C. The company works with a variety of payers, including Medicare, Medicaid, Medicare Advantage and commercial insurance companies.
More than 65% of practices in Aledade’s network are located in areas that have been federally designated as having a shortage of primary care health professionals. In the Medicare Shared Saving Program (MSSP) specifically, practices in Aledade’s networks serve more than twice the average of patients living in low-income communities.
Aledade said that in 2021, it helped the traditional Medicare program alone save more than $390 million through its network of accountable care organization in MSSP — with four of the top 10 performing accountable care organizations in MSSP for per-beneficiary savings being a part of its network. PMA Enhanced, an accountable care organization in Pennsylavnia that works with Aledade, was the top performing MSSP accountable care organization in the U.S. last year.
Dr. Lee Fleischer, a primary care physician at PMA Enhanced, testified that being a part of Aledade’s network was a decision that has yielded significant shared savings that have led to better care outcomes.
Partnering with Aledade allowed Dr. Fleischer’s practice to focus more on avoiding unnecessary hospitalization and re-hospitalization for patients, he said.
“If somebody went to the emergency room or was hospitalized, a lot of data shows that the post-hospital follow up is extremely critical for better patient care as well as for shared savings,” he said. “Being able to invest in that was huge for us, and I think a tremendous benefit to the patients. We avoided a ton of hospital readmissions over the last five years because of it.”
Using Aledade’s population health technology, PMA Enhanced reached out to 98% of recently hospitalized patients last year. The practice conducted medical visits with 50% of those patients within 14 days of discharge, which led to a 9% readmission rate, compared to the average readmission rate of 15.4% across MSSP.
Instead of feeling like he’s on a hamster wheel and needs to conduct an endless slew back-to-back 10-minute patient visits to generate enough income, Dr. Fleischer said partnering with Aledade allowed his practice to focus more on individual patients and keeping them healthy.
Mat Kendall, president of Aledade, said that he often hears this kind of feedback from accountable care organizations in the company’s network.
“I think our program allows our doctors to invest in their practices and allows them to give bonuses to their staff, and it allows them to expand their services so they can help more patients,” Kendall said in an interview. “So it really is a virtuous cycle.”
Nine out of every 10 practices in Aledade’s network will receive a shared savings check this year, and those checks will total more than $117 million, according to the company. Aledade said that on average, member practices earned shared savings payments equal to more than 20% of their annual Medicare fee-for-service revenue.
Photo: Hong Li, Getty Images
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September 25, 2022 at 08:01PM
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