AmeriHealth Caritas Pennsylvania and Lancaster General Health Community Care Collaborative Seek to Improve Health of Medicaid Patients Through Value-based Agreement

Addressing social determinants will be key to achieving positive health outcomes

August 19, 2019 - Harrisburg, Pa.

Harrisburg, Pa. — AmeriHealth Caritas Pennsylvania, a Medical Assistance (Medicaid) managed care plan serving central and northwestern Pennsylvania and part of the AmeriHealth Caritas Family of Companies, has entered into a value-based agreement with Lancaster General Health Community Care Collaborative in which the provider is paid based on its effectiveness in keeping patients healthy.

The agreement creates greater flexibility for Lancaster General Health Community Care Collaborative to address both medical and non-medical health care needs of AmeriHealth Caritas Pennsylvania’s Medicaid members. It is designed to fully align the standard health care payment model with the delivery of care to Medicaid beneficiaries.

In this agreement, AmeriHealth Caritas Pennsylvania and Lancaster General Health have agreed to share accountability for the total cost of providing health care services to Medicaid members receiving care from Lancaster General Health Community Care Collaborative providers. Revenue is higher for the provider if health care quality and cost-reduction targets are met or exceeded, and revenue is lower if those targets are not met.

“This agreement with Lancaster General Health Community Care Collaborative exemplifies our commitment to providing access to health care for our members,” said AmeriHealth Caritas Pennsylvania Market President Marge Angello. “It also represents an opportunity to strengthen our relationship with a health care provider in our community as our organizations continue the work to help members address the social, economic and environmental barriers to obtaining and maintaining good health.”

Lancaster General Health Community Care Collaborative is an accountable care organization that includes its not-for-profit health system, with a comprehensive network of care, including more than 300 primary-care and specialty physicians; outpatient and Urgent Care services; three hospitals  (Lancaster General Hospital, Women & Babies Hospital and Lancaster Rehabilitation Hospital); as well as more than 40 independent primary-care and specialty practices.

“This value-based care agreement supports our commitment to addressing social determinants of health,” said Angello. “Strong collaboration with our PCPs, community health workers and case managers is essential in improving health outcomes for our members, especially those with chronic diseases.”

 

About AmeriHealth Caritas Pennsylvania

AmeriHealth Caritas Pennsylvania is a Medical Assistance (Medicaid) managed care health plan serving 26 counties in Central and Northwestern Pennsylvania. Headquartered in Harrisburg, Pennsylvania, AmeriHealth Caritas Pennsylvania is a mission-driven company dedicated to helping members get care, stay well and build healthy communities. For more information, visit www.amerihealthcaritaspa.com.

 

About AmeriHealth Caritas

AmeriHealth Caritas is one of the nation’s leaders in health care solutions for those most in need. Operating in 13 states and the District of Columbia, AmeriHealth Caritas serves approximately 5 million Medicaid, Medicare, and Children’s Health Insurance Program (CHIP) members through its integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, and behavioral health services. Headquartered in Philadelphia, AmeriHealth Caritas is a mission-driven organization with more than 37 years of experience serving low-income and chronically ill populations. For more information, visit www.amerihealthcaritas.com.