Aetna Better Health® of Louisiana (ABH-LA), a CVS Health company, today announced it has been selected as one of three Medicaid health plans in the State of Louisiana to participate in the Centers for Medicare & Medicaid Services’ (CMS) Primary Care First (PCF) program.
Primary Care First is a voluntary, five-year alternative payment model aimed at reducing health care spending by preventing avoidable inpatient hospital admissions and improving quality and access to care for all beneficiaries. With a focus on supporting care for patients who have chronic conditions and serious illnesses, all payment options reward value and quality by offering an innovative payment structure to support delivery of advanced primary care. The model aims to reduce administrative burdens and empower primary care providers to spend more time caring for patients while reducing overall health care costs.
“Since its inception in 2015, Aetna Better Health has worked with our provider partners on value-based payment solutions that improve the health outcomes of the members we serve,” said Aetna Better Health of Louisiana CEO Rick Born. “The Primary Care First program provides another avenue to enhance our provider relationships and further transform the health care of our fellow Louisianans.”
Five primary care functions make up the PCF model, including:
- Access and continuity
- Care management
- Comprehensiveness and coordination
- Patient and caregiver engagement
- Planned care and population health
- The Centers for Medicare & Medicaid Services selected ABH-LA to participate in the PCF program because of its continuum of value-based models and for its ability to meet providers in their preferred setting. The health plan also demonstrates an expertise to help providers implement and advance care and population management capabilities through various programs that improve the health outcomes of their patients.
Aetna Better Health of Louisiana currently serves approximately 140,000 Healthy Louisiana Medicaid members across the state.