- Wellvana is exclusively partnering with AdventHealth’s Florida primary care network to aid in its transition to value-based care (VBC) for Medicare and Medicare Advantage patients, starting in January.
- The collaboration aims to improve patient access to healthcare professionals, close care gaps, and support quality, risk adjustment, and key benchmarks.
- This partnership signifies a shift from volume-based reimbursement to quality-based reimbursement in healthcare payment models for Medicare and Medicare Advantage recipients, with the goal of reducing the total cost of care.
Wellvana, a value-based care enabler, has partnered exclusively with AdventHealth’s primary care network in Florida to transition it to a value-based care (VBC) system for Medicare and Medicare Advantage patients.
According to Wellvana, it will devote clinical teams to assist AdventHealth to increase patient access to RNs, social workers, and trained pharmacists; provide care gap closure coordination; and offer support on Quality, Risk Adjustment, and key benchmarks. The partnership, planned to commence in January, is reached as AdventHealth undergoes a transition of its entire primary care network in Florida to value-based care for Medicare and Medicare Advantage patients.
“[T]his partnership is designed … lower the total cost of care and improve the health of people and families throughout Florida,” said Kyle Wailes, Chief Executive Officer of Wellvana.
The collaboration between the two entities marks a shift in healthcare payment models, particularly for Medicare and Medicare Advantage recipients. Historically, healthcare providers received compensation based on the volume of individual services provided, which critics claim holds the potential to lead to fragmented care. The transition to value-based care introduces a system where reimbursement is contingent on the quality of care, patient outcomes, and cost reduction.
“AdventHealth and Wellvana share a vision of redesigning primary care so that it offers a more balanced approach to health, driven not just by sick care, but also wellness and prevention. That starts with integrated, accessible, and affordable primary care,” said Bryan Stiltz, Chief Executive Officer of AdventHealth’s Primary Care Network. “Guiding our high-performing network through the transition to full-risk requires a dependable and innovative partner.”
In June, The Capitolist reported that AdventHealth was exiting Florida’s nursing home market, upon confirmation from the provider, citing the costs necessary to run such facilities as exceeding what the company is willing to invest.
The health system, which ranks as the state’s largest by member hospitals, validated that it sold all ten of its skilled nursing facilities to third-party operators. Eight were located in Florida, while a single facility was offloaded in both Texas and Kansas.
The decision came on the heels of a reported $838 million loss in 2022, as published by Becker’s Hospital Review in March. According to the report, AdventHealth saw a decrease of approximately $1.2 billion in its investment returns compared to a gain of $524.9 million in 2021. Although the organization still achieved a profitable operating income of $283.8 million, it declined from the previous year’s $994.6 million due to an 11 percent increase in expenses.