NEWARK, Del. – February 22, 2019
Christiana Care Health System and AmeriHealth Caritas Delaware announced that they have formed a value-based collaboration aimed at meeting or exceeding measurable health goals for Medicaid-eligible Delawareans.
It’s part of the shift from volume to value, which means that, instead of being paid for individual tests, procedures and visits, providers like Christiana Care will see their compensation tied more directly to health outcomes.
AmeriHealth Caritas Delaware is one of the managed care health plans which serve Delaware residents on Medicaid, a health insurance program for low-income residents.
This agreement puts Christiana Care’s and AmeriHealth Caritas Delaware’s commitment to quality on paper with measurable performance goals in seven areas the state has identified as key opportunities to improve quality and save costs. Six of the seven goals come from the Healthcare Effectiveness Data and Information Set, or HEDIS, a commonly used set of performance measures.
Diabetes care. Though this chronic condition is incurable, quality health care to manage diabetes can prevent deadly and debilitating complications. The goal is for patients to reduce their blood sugar levels.
Medication management for people with asthma. Medication can reduce the need for rescue inhalers and cut down on hospital visits, but studies have found that up to 60 percent of children don’t take their daily asthma medication. The goal is to improve patients’ use of asthma medications.
Cervical cancer screening. Once the most common cause of cancer death for American women, cervical cancer death rates declined by more than 60 percent in the second half of the 20th century. That was largely thanks to the Pap smear, which can identify abnormalities before they turn cancerous, but too many women still don’t have access to regular screening. The goal is to improve access to cervical cancer screening.
Breast cancer screening. Mammograms can catch breast cancer at an earlier stage, when treatments are more effective. This quality measure rates providers on how many of their patients have regular screening.
Body-mass index assessments. Obesity is a factor in an estimated one in five deaths in America. This quality measurement looks at what percentage of adults had their body-mass index — a ratio of a person’s height to their weight — documented in the current or previous years.
Prenatal and postpartum care. Medical care early in a pregnancy is a crucial part of a healthy pregnancy and birth. This quality measurement also documents what percentage of women had a postpartum visit between 21 and 56 days after delivery.
30-day hospital readmission rates. The percentage of patients who return to the hospital within 30 days of leaving one is often used to measure the hospital’s quality.
“Paying for value caters to our institutional strengths, as efficient care is a core part of the Christiana Care Way,” said Barry Dahllof Jr., vice president, Enterprise Contracting and Payor Relations at Christiana Care. “Thousands of people in Delaware are affected by the health issues that we aim to address through this initiative, and we’re confident in our ability to meet these standards because our health care teams already have a deep commitment to providing value-based care.”
The contract, which was signed in June and retroactive to January 2018, begins with a data collection period so Christiana Care, AmeriHealth Caritas and the State of Delaware can develop a baseline against which they can make improvements.
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Headquartered in Wilmington, Delaware, ChristianaCare is one of the country’s most dynamic health care organizations, centered on improving health outcomes, making high-quality care more accessible and lowering health care costs. ChristianaCare includes an extensive network of primary care and outpatient services, home health care, urgent care centers, three hospitals (1,430 beds), a freestanding emergency department, a Level I trauma center and a Level III neonatal intensive care unit, a comprehensive stroke center and regional centers of excellence in heart and vascular care, cancer care and women’s health. It also includes the pioneering Gene Editing Institute.
ChristianaCare is nationally recognized as a great place to work, rated by Forbes as the 2nd best health system for diversity and inclusion, and the 29th best health system to work for in the United States, and by IDG Computerworld as one of the nation’s Best Places to Work in IT. ChristianaCare is rated by Healthgrades as one of America’s 50 Best Hospitals and continually ranked among the nation’s best by U.S. News & World Report, Newsweek and other national quality ratings. ChristianaCare is a nonprofit teaching health system with more than 260 residents and fellows. With its groundbreaking Center for Virtual Health and a focus on population health and value-based care, ChristianaCare is shaping the future of health care.
About AmeriHealth Caritas Delaware
AmeriHealth Caritas Delaware, part of the AmeriHealth Caritas Family of Companies, is one of the Medicaid managed care plans that participate in the Diamond State Health Plan and Diamond State Health Plan-Plus programs. AmeriHealth Caritas Delaware helps Delawareans get proper care and stay well, working with communities in need to achieve positive health outcomes throughout the state. For more information, visit www.amerihealthcaritasde.com.
About AmeriHealth Caritas
AmeriHealth Caritas is part of the Independence Health Group in partnership with Blue Cross Blue Shield of Michigan. 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 approximately 5.1 million Medicaid, Medicare and Children’s Health Insurance Program (CHIP) members through its integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative 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. For more information, visit www.amerihealthcaritas.com.