Equality Health Enters into Risk Based Contracting in Arizona and California

Published: January 9, 2020

First-ever professional capitation agreements and shared risk contracts to be implemented in 2020

Phoenix, Arizona, January 9, 2020 – Equality Health®, the Phoenix-based whole-health delivery system, announces that health plan partners in Arizona and California have agreed to contracts that will allow Equality Health to assume a larger percentage of risk from managed care organizations in these states. The new risk-based contracts are the result of two years of successful improvements in quality of care and lowering of healthcare costs. Equality Health taking on additional risk helps plans and practices optimize performance because doctors can spend less time on administrative tasks and more time caring holistically for their patients.

This new venture is a testament to the legitimacy of the whole-person care model innovated by Equality Health, rooted in population-specific approaches and data-driven methodologies for ‘next generation’ healthcare. This initiative would not be possible without the dedication of independent physicians working in partnership with Equality Health.

“Our organized whole-health delivery system positions health plans and physician practices for success within this new reimbursement structure and the decision to take on risk-based contracts speaks volumes about our proven approach,” said Hugh Lytle, Founder and CEO of Equality Health. “Our contracts are designed to support plans and practices and at this point, all are in some form of shared risk. We are extremely grateful to have health plan partners who, through our collaborative partnerships, support this transition toward value-based care.”

The move is in response to the recent decision by the Arizona Health Care Cost Containment System (AHCCCS)—the state’s Medicaid program—to move from paying for volume to paying for value. In Arizona specifically, AHCCCS continues to align incentives for managed care organizations and providers, requiring up to 65 percent of managed care contracts adhere to value-based purchasing arrangements by 2021, with increasing levels of clinical and financial risk.

“AHCCCS initially began working to align care delivery with payment reform in 2013 when we first started implementing value-based purchasing. We continue to move the AHCCCS provider network to incentivize quality outcomes versus quantity in order to inspire new ideas and improvements in the delivery system for members,” said Jami Snyder, Director of AHCCCS. “As healthcare continues to transform, addressing social determinants of health, those factors beyond healthcare that contribute to a person’s overall health and wellness, is one example that we expect will be a differentiator for our state as we continue to identify ways to improve health outcomes while also slowing costs.”

Equality Health has the proven know-how to support partners to help achieve higher quality and reduce inefficiencies and maintain the necessary integrated care standards. Equality Health partners with health plans to equip practices with the technology, training, aligned incentives, and practice management support necessary to engage with AHCCCS’s vision for healthcare while building a more sustainable whole-person care model.

“Over the last three years, we have built out our technology, care management processes, ambulatory delivery system and many other offerings that invest in ways to expand the primary care model and produce outstanding results,” said Lisa Stevens Anderson, President of Equality Health’s Management Services organization. “We believe this approach to incentivizing quality care is the answer to succeeding in how Arizona, California and other states, will administer government-funded healthcare in the future.”

The company aims to cultivate and expand practice transformation by supporting health plans and providers to address social determinants of health before they lead to situations that cost the healthcare system more than they should. Arizona has been acknowledged as a pioneer in serving the Medicaid population as the state has made great strides to integrate care across the care-continuum and coordinate physical and behavioral healthcare across the state.

Equality Health’s initiative to take on some of the risk for providers, will allow them to manage individual care more efficiently, resulting in better outcomes and, in turn, more satisfied patients. The company’s nationally proven tech-enabled model is already being deployed in markets outside of Arizona. New contracts begin this year in southern California and soon in Texas at the request of health plan partners, as a means of advancing their mission to provide better access to personalized, quality healthcare for all.

About Equality Health

Equality Health, LLC is a Phoenix-based whole-health delivery system focused on improving care delivery for diverse populations with culturally sensitive programs that improve access, quality, and member trust. Through an integrated technology and community resources platform, culturally competent provider network and unique population-specific model, Equality Health helps managed care plans and health systems improve health outcomes while simultaneously making the transition to risk-based accountability. For more information about Equality Health, visit www.equalityhealth.com or follow @EqualityHealth on Facebook, @EqualityHealth on Twitter, and @EqualityHealth on LinkedIn.