Universal Health Services, one of the nation’s largest hospital operators, has deepened its partnership Seattle-based primary clinic operator Vera Whole Health as part of a value-based care partnership meant to bolster UHS’ clinically integrated delivery network.
UHS has also made equity investment in Vera as part of the deal.
The companies initially started working together through the UHS-affiliated health plan Prominence Health Plan, which is based out of Reno, Nevada. In January, Vera opened up two co-branded care centers meant to provide health coaching and primary care services to Prominence commercial and Medicare Advantage members.
“As we were working them, we were continually impressed with their commitment to value, which is really important from their side because they’re the ones underwriting the risk,” said Vera Whole Health CEO Ryan Schmid.
That philosophical alignment led to conversations about how Vera could provide advanced primary care services for more Prominence patients. The partnership provides a base in which to grow Vera’s presence in markets like Las Vegas and other areas where Prominence has a footprint. The health plan covers more than 100,000 lives in Nevada and Texas.
The relationship could also lead to a larger nationwide expansion. UHS and its affiliates operate hundreds of hospitals and care facilities across 37 states, Washington, D.C., Puerto Rico and the United Kingdom.
A Deep-dive Into Specialty Pharma
A specialty drug is a class of prescription medications used to treat complex, chronic or rare medical conditions. Although this classification was originally intended to define the treatment of rare, also termed “orphan” diseases, affecting fewer than 200,000 people in the US, more recently, specialty drugs have emerged as the cornerstone of treatment for chronic and complex diseases such as cancer, autoimmune conditions, diabetes, hepatitis C, and HIV/AIDS.
Vera has signed a number of partnerships with health plans and health systems as healthcare stakeholders increasingly look at stronger investment in primary care as a pathway towards controlling cost and improving quality in value-based payment models.
Last year, the company launched a partnership with Blue Cross and Blue Shield of Kansas City in 2018 to open three clinics available exclusively to specific BCBS KC members as part of a more effective strategy to manage care.
Primary care had traditionally been deemphasized in the fee-for-service healthcare system, primarily serving as a referral pathway toward more expensive (and profitable) specialty care.
Like many other clinic operators, Vera pitches its service as a way to drive lower cost and higher quality care through better preventive care and care coordination.
The company says its clinic and health coaching model is able to drive up to a 25 percent reduction in healthcare costs due to appropriate ER and specialty care utilization and better management of chronic health issues.
Schmid said the two companies were still finalizing a model for the partnership, but he could foresee a system where a health plan network includes UHS facilities and is wrapped around Vera’s primary care clinics.
If a patient unnecessarily comes into the emergency department they can be redirected back to primary care and if a patient is discharged from the hospital without a PCP then they can transitioned into Vera’s network.
Ultimately, the idea is to create a seamless experience where patients are automatically directed to the appropriate level of care.
“I think there’s a very clear shift to value happening across the country where there’s greater and greater demand to risk bearing contracts that can deliver on the value. It’s moved beyond lip service,” Schmid said.
Photo: Nicolas Mero, Getty Images
