PHOENIX and TAMPA, Fla., April 15,
2019 /PRNewswire/ -- Care1st Health Plan Arizona, a
WellCare Health Plans, Inc. (NYSE: WCG) company, signed a
value-based agreement with Maricopa Integrated Health System (MIHS)
on Oct. 1, 2018 to launch the
Hepatitis C Center of Excellence program to treat Medicaid members
in Maricopa County with the
infectious liver disease under a unique value-based bundled payment
arrangement. Experts at the Institute for Strategy and
Competitiveness at Harvard University
estimate that this is the first time a Medicaid plan in the U.S.
has offered bundled payments as part of a value-based agreement for
hepatitis C treatment.
Approximately 90,000 individuals are living with hepatitis C in
Arizona, making it one of the
state's most commonly reported infectious diseases. Through the
partnership, Care1st Health Plan Arizona will collaborate with MIHS
hepatologists at Maricopa Medical Center to evaluate and treat 100
members with hepatitis C by administering anti-viral medication
targeted at the hepatitis C virus. The medication, which is taken
daily for approximately 12 weeks, is covered by Care1st Health Plan
Arizona and is available to Medicaid members at no cost.
Participating members will also work with MIHS navigators and
community health workers to ensure program compliance and to help
connect them to needed social and human services such as food,
housing, transportation and more.
Under the value-based contract, participating MIHS providers
receive bundled payments to help drive quality health outcomes.
Bundled payments are identified as one of the more advanced levels
of compensation in value-based contract payment structures under
the Centers for Medicare and Medicaid Services' (CMS) Learning
Action Network (LAN). These payments help contain costs and promote
better health outcomes while allowing for innovation at the
clinical practice level.
"Hepatitis C is a highly infectious liver disease that, without
proper management or treatment, can lead to potentially fatal
outcomes," said Gerard Quigley, DNP,
director of the hepatitis C clinic at MIHS. "By collaborating with
Care1st Health Plan Arizona, we can help treat the disease sooner
and potentially help mitigate the spread of the disease across our
state."
"Hepatitis C impacts thousands of Arizonans each year," said
Scott Cummings, state president,
Care1st Health Plan Arizona. "As a health plan serving thousands of
Medicaid members across our state, we're excited to partner with
MIHS to launch this innovative initiative and help our members
access quality, affordable care and treatment."
"This unique bundled payment approach tied to quality
outcomes allows the provider to seek innovative and more
efficient care processes than the current fee-for-service
payment model permits," said Dr. Satya
Sarma, chief medical officer, Care1st Health Plan Arizona.
"Becoming more efficient and more focused on quality
will allow us to improve access and maximize the
effectiveness of care for our members who have this
serious condition."
During the yearlong Hepatitis C Center of Excellence
initiative, Care1st Health Plan Arizona will measure quality
and utilization outcomes from the program and will assess whether
to expand the program.
About WellCare Health Plans, Inc.
Headquartered in
Tampa, Fla., WellCare Health
Plans, Inc. (NYSE: WCG) focuses primarily on providing
government-sponsored managed care services to families, children,
seniors and individuals with complex medical needs primarily
through Medicaid, Medicare Advantage and Medicare Prescription Drug
Plans, as well as individuals in the Health Insurance Marketplace.
WellCare serves approximately 5.5 million members nationwide as of
December 31, 2018. For more
information about WellCare, please visit the company's website at
www.wellcare.com.
About Maricopa Integrated Health
System (MIHS)
Located in Phoenix, Arizona,
Maricopa Integrated Health System has a proud tradition of being
both the community safety net health care system, with a mission
and commitment to serving the underserved and Arizona's only public teaching hospital. MIHS
consists of Maricopa Medical Center, the only Level I Trauma Center
in Arizona verified by the
American College of Surgeons to care for both adults and children,
Arizona's only nationally verified
Burn Center serving the entire Southwestern United States, MIHS's McDowell
Healthcare Center, which is the largest provider of HIV primary
care in Arizona, the Refugee
Women's Health Clinic, the Arizona Children's Center, two
behavioral health centers, and 12 neighborhood Family Health
Centers. To learn more about MIHS, please visit www.mihs.org.
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SOURCE WellCare Health Plans, Inc.