(WILMINGTON, Del. – June 28, 2019), Through a new health care reimbursement approach based on keeping Medicaid beneficiaries healthy, Highmark Health Options, Delaware’s largest Medicaid managed care organization, and Christiana Care Health System have entered a partnership designed to bring greater value to the State of Delaware. This new value-based payment agreement is a cutting edge approach committed to higher quality care at a lower cost.
“Highmark Health Options is dedicated to being a leader in value-based payment and providing our members access to quality care and healthier outcomes,” said Todd Graham, president and CEO, Highmark Health Options. “We are aligned with Christiana Care and the State of Delaware in providing the right care at the right time in the most appropriate setting. We are proud to join Christiana Care in transforming care for our members.”
The agreement between Delaware’s largest health system and largest Medicaid managed care organization creates greater flexibility for Christiana Care to address both medical and non-medical health care needs of Highmark Health Options Medicaid members. The agreement fully aligns the health care payment model with the delivery of high quality, valuable care to Highmark Health Options members. Under the new structure, revenue is higher 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.
“Together we are transforming the health system to achieve better health at lower costs,” said Janice E. Nevin, M.D., MPH, president and 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 Highmark Health Options Medicaid members. 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 Highmark Health Options in transforming care for so many Delawareans.”
“We are grateful for this partnership between Christiana Care Health System and Highmark Health Options that places a new emphasis on the social determinants of health in achieving better health outcomes,” said Department of Health and Social Services Secretary Kara Odom Walker, M.D, MPH, MSHS, whose agency oversees Medicaid coverage for about 225,000 Delawareans through the Division of Medicaid and Medical Assistance. “Our health care system needs the flexibility to better address such social determinants as housing, transportation, employment and access to quality food that affect a person’s health and their quality of life. This value-based payment agreement provides Christiana Care providers and Highmark Health Options officials with the ability to meet more of those needs that happen outside of a doctor’s office.”
This model, in which a health system has partnered with the state’s largest Medicaid managed care organizations in a total-cost-of-care arrangement that includes upside and downside risk, represents an exciting step forward in value-based care for Delaware. In this agreement, Christiana Care and Highmark Health Options have agreed to share accountability for the total cost of providing health care services to Medicaid members being cared for by Christiana Care providers.
The value-based payment agreement applies to the Delaware Medicaid beneficiaries managed by Highmark Health Options who are attributed to Christiana Care as their primary health care provider. The agreement does not restrict freedom of choice or access to care for these Medicaid beneficiaries.
About Christiana Care Health System
Headquartered in Wilmington, Delaware, Christiana Care is one of the country’s most dynamic health systems, centered on improving health outcomes, making high-quality care more accessible and lowering health care costs. Christiana Care includes an extensive network of outpatient services, home health care, medical aid units, two hospitals (1,227 beds), 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. Christiana Care is a not-for-profit teaching health system with more than 260 residents and fellows. We are continually ranked by US News & World Report as a Best Hospital. With our unique, data-powered care coordination service and a focus on population health and value-based care, Christiana Care is shaping the future of health care.
About Highmark Health Options
Highmark Health Options, a leading Medicaid managed care organization, provides best in class health care programs that promote the ongoing health and wellness of our members. Highmark Health Options, serves Delaware Medicaid, Delaware Healthy Children Program (DHCP) members and Long Term Care (DSHP Plus) members.