WellCare Signs Value-Based Reimbursement Agreement with Choice Health Care Network
Agreement Aligns Payment with Health Outcomes Achieved
ATLANTA and TAMPA, Fla., March 31, 2016 /PRNewswire/ -- WellCare of Georgia, a subsidiary of WellCare Health Plans, Inc. (NYSE: WCG), a leading provider of managed care services for government-sponsored health care programs, and Choice Health Care Network, LLC (CHCN), a leading health care network that provides for a wide variety of comprehensive, primary care ancillary and specialty services through community-based health care centers in the state of Georgia, including federally qualified health centers and multispecialty medical practice providers, today announced an agreement that will align incentives to drive quality and efficiency of care achievements to help improve health outcomes and patient engagement for WellCare of Georgia members in the metro Atlanta area.
Under this value-based reimbursements agreement, WellCare of Georgia will provide incentive payments to CHCN's health care providers for quality-based improvements in certain Healthcare Effectiveness Data and Information Set (HEDIS®) measures, a tool used by more than 90 percent of America's health plans to measure performance on important dimensions of care and service.
CHCN's health care providers that manage care for WellCare of Georgia's Medicare members will receive incentive payments for obtaining a certain Star Rating level, a system created by Centers for Medicare & Medicaid Services (CMS) that measures and scores providers' performance on several categories, including quality of care and customer service.
CHCN provides comprehensive primary and preventive care, including health, dental, mental health and substance abuse services to the Atlanta community through The Family Health Centers of Georgia, Inc., Four Corners Primary Care Centers, Inc. and Southside Medical Center, which are all federally qualified health centers (FQHC). These health care providers are currently managing care for approximately 9,000 WellCare of Georgia members.
FQHCs are community-based health centers that serve a variety of urban and rural federally designated medically underserved populations and that deliver quality health care services, including preventive, oral, vision, behavioral health, and substance abuse treatment, to persons of all ages, regardless of their ability to pay or health insurance status. FQHCs are a critical part of the health care safety net. The National Association of Community Health Centers has recognized the Southside Medical Center for having one of the best primary health care delivery systems for the medically underserved in the nation.
"WellCare of Georgia is pleased to partner with CHCN in providing our members with increased access to coordinated health care that emphasizes primary and specialty care in an effort to improve and sustain positive health outcomes," said Roman Kulich, WellCare's region president, Georgia and South Carolina.
For more information about CHCN, or to schedule a tour or appointment call 770-217-0997 or toll free at 888-830-7773, or visit www.choicehealthcarenetwork.com.
As of Dec. 31, 2015, WellCare serves approximately 585,000 Medicaid and PeachCare for Kids® plan members, 36,000 Medicare Advantage plan members and 22,000 Medicare Prescription Drug Plan members in Georgia. To learn more about how we care for Georgians watch Gloria's story at http://youtu.be/qyn-nywze04.
About WellCare Health Plans, Inc.
Headquartered in Tampa, Fla., WellCare Health Plans, Inc. (NYSE: WCG) focuses exclusively on providing government-sponsored managed care services, primarily through Medicaid, Medicare Advantage and Medicare Prescription Drug Plans, to families, children, seniors and individuals with complex medical needs. WellCare serves approximately 3.8 million members nationwide as of Dec. 31, 2015. For more information about WellCare, please visit the company's website at www.wellcare.com or view the company's videos at https://www.youtube.com/user/WellCareHealthPlan.
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SOURCE WellCare Health Plans, Inc.
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