Emory Healthcare Pilots Senior Care Model With WellPoint

WellPoint, the nation's second-largest health insurer, and Emory Healthcare in Atlanta have agreed to partner on value-based reimbursement models and risk-based payments for elderly patients.

Under the agreement, Emory Healthcare will implement WellPoint subsidiary CareMore Health System's clinical care model for the health system's Medicare Advantage population. CareMore, which was acquired by WellPoint in 2011, operates both health plans and a medical group. Emory Healthcare includes six hospitals and 1,800 physicians.

Emory Healthcare President and CEO John Fox said in a news release the collaboration, similar to an accountable care organization structure, will be attractive to patients due to its emphasis on reducing costs and improving health outcomes.

"Seniors with the [CareMore] Medicare Advantage plan will experience more interactive care and a more tailored treatment plan to reduce the possibilities of them having a major event, such as a visit to the emergency room or an invasive surgery," Mr. Fox said. "It's a win-win collaboration for all because we will help in improving the quality of life for our patients, while lowering healthcare costs."

The deal is expected to go live early next year. Emory Healthcare will be the first provider network in the Southeast to partner with CareMore, which has a heavier presence in California and Arizona.

More Articles on Hospitals and Population Health:
Humana Strikes 2 Accountable Care Agreements
The Risks of Provider-Operated Health Plans: Are the Rewards Worthwhile?
RAC Launches Clinical Integration, Accountable Care Accreditation Programs

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