5 things to know about the first hep C bundled payment program

Care1st Health Plan Arizona, a subsidiary of WellCare Health Plans, launched what it believes is the first Medicaid bundled payment program for hepatitis C treatment, according to a feature in Managed Healthcare Executive

Five things to know about the program:

1. Launched in April, the program is part of a one-year value-based agreement for hepatitis C treatment that Care1st inked with Maricopa Integrated Health System in Phoenix.

2. Full payment under the program is dependent on a cure, which is defined as full eradication of the virus. As a result, the program holds providers accountable for managing medication adherence and patient access to hepatitis C treatment, according to Managed Healthcare Executive.

3. Under the yearlong program, hepatologists at Phoenix-based Maricopa Medical Center will manage treatment for 100 Medicaid patients with hepatitis C. The patients will be prescribed antiviral medication to be taken for eight to 12 weeks.

4. To ensure adherence and successful treatments, physicians and care managers will follow up with patients once the medication is administered. Patients will also be monitored at Care1st's Hepatitis C Center of Excellence, according to the report.

5. After results are in for the program, Care1st will determine whether it should continue or even expand the initiative. Satya Sarma, MD, Care1st Health Plan Arizona CMO, told Managed Healthcare Executive that physicians were consulted throughout the program's development to ensure the best results.

"We wanted to leverage their clinical expertise and incorporate their input into the design of our model," Dr. Sarma said. "We wanted to understand the scope of the clinical workflows as well as address any concerns that arose about a different payment model."

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