Value-based care is a model of managed care that incentivizes health care providers to emphasize quality of care over the number of patients treated. This health care delivery model reimburses primary care providers based on the health outcomes of their patients and the quality of service rendered.
Inherent to the success of any value-based care model is building trust in the community to increase participation among providers. CareSource, a nationally recognized nonprofit health plan that leads the nation with its innovative value-based care models, works closely with providers to provide high-quality care that improves health outcomes.
“At CareSource, we have long recognized that our health care provider partners are vital to the success of value-based care initiatives and our goal of improving the whole health of Georgians,” said Jason Bearden, CareSource Georgia president. “We have created a wide range of customized initiatives that reward partners who provide high-quality, cost-effective care that improves health outcomes for our members — and currently more than 60% of our members are seeing a provider participating in these value-based care programs.”
In Georgia, providers participating in value-based care models have elevated the quality and access to health care across the state. Children (ages 3-21) whose providers participate in a value-based care model have demonstrable improvements in health care outcomes compared to children who are seen by providers who do not participate, according to CareSource real-time data.
- 47% of children who are CareSource members and who see a provider participating in a value-based care model received a well-child visit this year. This compares to only 37% among children who do not go to a provider participating in a value-based care model.
- In 2021, there was a 41% jump in preventative dental visits compared to the previous year.
- Children seen within a VBC model are 8% more likely to complete seven recommended 2-year-old vaccination series.
These measurements are important because an increased number of wellness checks, completions of vaccination schedules and early monitoring of growth and development are evidence of improved preventative care treatments that can thwart many illnesses and diagnose more serious diseases at earlier stages.
CareSource recently created an award to honor the best of the best of these providers for their accomplishments. The CareSource Quality Achievement Award recognized four health care organizations across Georgia for their achievements in quality metrics. The inaugural winners of this award are:
- Pediatric Associates of Savannah (Savannah, Whitemarsh Island, Pooler)
- Sumter Pediatrics (Americus, Leesburg, Montezuma)
- White’s Pediatrics (Calhoun, Chatsworth, Dalton)
- Longstreet Clinic, (Buford, Baldwin, Braselton, Gainesville, Oakwood)
Each of these providers achieved noteworthy improvements in categories that directly affect the health of their patients. For example, Sumter Pediatrics achieved the biggest percentage improvement year over year in child and adolescent well check visits and flu vaccines.
“We are proud to partner with CareSource to provide our patients with high quality primary care services” said Dr. Nelson Madrazo of Sumter Pediatrics. “When health plans and providers work together for the good of children and their families, we elevate the quality of care for all Georgians.”
Last week we were honored and excited to be recognized by CareSource as the top performer in Georgia for five quality measure categories, several focused around women's and children's health. Read more: https://t.co/tuNSnscA67 pic.twitter.com/ale7BEON9N
— Longstreet Clinic (@longstclinic) November 23, 2022
CareSource is in a unique position to help improve the quality of health care and prioritize community, providers and members ahead of profit. A not-for-profit designation further ensures that CareSource is not beholden to investors and thus able to reinvest in the communities it serves. In fact, for more than 30 years CareSource has built trusted relationships with the mission of transforming health care with innovative programs that address the social determinants of health, health equity, prevention and access to care.