Aledade, Humana Expand Partnership in Medicare Advantage
Aledade, which describes itself as the nation’s largest network of independent primary care, has inked a 10-year collaboration deal to provide value-based primary care for Humana’s Medicare Advantage members from in-network Aledade-enabled physicians.
The two companies have been working together since 2019 in a limited number of markets, where they were able to increase primary care visits and reduce inpatient hospitalizations by 5 percent and reduce readmissions by 12 percent, according to shared company data. By the end of 2022, more than 100,000 patients in Humana’s network received care under a value-based agreement with an Aledade-enabled physician practice.
Building on their existing relationship, the two companies plan to phase in the 10-year term for current and new state-wide agreements, which include a pathway to full risk. The collaboration with Humana will continue to grow as new practices and prospective markets join Aledade’s nationwide network. The company works with more than 1,500 primary care practices and health centers around the country, helping with data analytics; care management; patient outreach tools and regulatory expertise; and local, hands-on support.
“Through this value-based relationship, Aledade and Humana are making a decade-long commitment to bringing better care to patients, better support to community-based primary care, and lower costs for society,” said Farzad Mostashari, M.D., co-founder and CEO of Aledade, in a statement. “Making a lasting change in our healthcare system requires a long-term commitment, and that’s exactly what Humana and Aledade are doing for patients all across the country.”
Humana has about 8.6 million Medicare members in all 50 states, Washington, D.C., and Puerto Rico, as of January 2023. Approximately 5.6 million of those members are enrolled in a Medicare Advantage plan, which includes members affiliated with providers in value-based and standard Medicare Advantage settings. Humana has an extensive and growing value-based care presence with more than 1,000 value-based relationships across 43 states and Puerto Rico, as of Dec. 31, 2022, including its own 235 CenterWell- and Conviva-branded senior-focused primary care facilities.
To support its rapidly growing network and further enhance its ability to scale with quality, Bethesda, Md.-based Aledade has acquired Curia, a value-based care analytics company that uses practical applications of artificial intelligence (AI) to optimize the targeting of patient care and engagement programs. Aledade said the acquisition would enhance its ability to extract valuable insights from disparate data sources, provide more accurate predictions using past data and optimize primary care workflows through cutting-edge AI algorithms.
Curia leverages AI and machine learning to automate the core analytical processes needed to identify risk gaps, predict the likelihood of adverse health outcomes like preventable hospitalizations and optimize the targeting of care and engagement programs. Aledade’s acquisition of Curia follows a pilot leveraging Curia’s technology and talented team of data scientists, software engineers and business strategists in the targeting of comprehensive advance care planning services to the patients who need them most. Using the predictive algorithm developed by Curia, Aledade was able to identify more than 8,000 patients facing the highest risk for mortality in the next two years and work with primary care practices in its national network to enroll these patients in a CACP facilitation. Aledade is exploring other use cases for targeted care interventions.
