The value-based program is designed to improve patient health, reduce unnecessary cost and promote accountable care at home with quality and cost-efficiency incentives
BAYADA Home Health Care and AmeriHealth Caritas today announced they have entered into a value-based agreement to improve patient health, reduce unnecessary cost and promote accountable care at home.
Developed as part of AmeriHealth Caritas’s PerformPlus® suite of value-based contracting programs, the agreement is built on a core set of balanced measures to align incentives among providers, like BAYADA, and payers, like AmeriHealth Caritas, in a shared goal of increasing positive patient outcomes and economic stewardship.
“By incentivizing providers for better outcomes and efficiency, we help keep our members healthier and, as a result, out of the hospital and emergency room,” said AmeriHealth Caritas Executive Vice President of Health Services Marilyn Eckley. “This new program is a natural step in our continued relationship with BAYADA to help our members live in their own homes and communities. BAYADA’s long track record of delivering standard-setting home health services made it a clear choice for our first value-based agreement with a home health services provider.”
As one of the largest providers of home care to managed care members in the country, BAYADA’s unique multi-specialty home care capabilities provide critical services to the diverse membership of AmeriHealth Caritas’ health plans. By leveraging BAYADA’s depth and breadth of services for Medicaid and Medicare Advantage members, this value-based relationship provides incentives for reaching important outcomes and efficiency targets.
Through the program, BAYADA will receive financial incentives for fulfilling predetermined targets based on the following quality metrics:
- Potentially preventable hospital admissions;
- Potentially preventable hospital re-admissions;
- Potentially preventable emergency room visits;
- Healthcare Effectiveness Data and Information Set (HEDIS®) measures, which track quality of care in five domains including effectiveness of care, access and availability of care, experience of care, utilization and relative resources use, and health plan descriptive information; and
- Missed shift rate, which signifies the number of agency-related hours missed for any BAYADA home health aide or nurse.
“BAYADA is pleased to enter into this value-based agreement with another innovative and mission-aligned organization like AmeriHealth Caritas, which shares our commitment to improving client outcomes and embracing efficiency,” said BAYADA Home Health Care CEO David Baiada. “We are proud to play a collaborative role in building health communities that improve the continuum of care for our patients.”
The program will extend across all of BAYADA’s specialties, including the company’s home health, hospice, personal care, adult nursing and pediatric practices. It will include AmeriHealth Caritas’ full-risk managed care health plans in Delaware, Pennsylvania, and any potential future markets served by both organizations.
About AmeriHealth Caritas
AmeriHealth Caritas is one of the nation’s leaders in health care solutions for those most in need. Operating in 11 states and the District of Columbia, AmeriHealth Caritas serves more than 5 million Medicaid, Medicare, and Children’s Health Insurance Program (CHIP) members through its integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, and behavioral health services. Headquartered in Philadelphia, AmeriHealth Caritas is a mission-driven organization with more than 35 years of experience serving low-income and chronically ill populations. AmeriHealth Caritas is part of the Independence Health Group in partnership with Blue Cross Blue Shield of Michigan. For more information, visit www.amerihealthcaritas.com.
For more information, visit www.bayada.com.
The Editorial Team at Healthcare Business Today is made up of skilled healthcare writers and experts, led by our managing editor, Daniel Casciato, who has over 25 years of experience in healthcare writing. Since 1998, we have produced compelling and informative content for numerous publications, establishing ourselves as a trusted resource for health and wellness information. We offer readers access to fresh health, medicine, science, and technology developments and the latest in patient news, emphasizing how these developments affect our lives.
