WellCare and Oakhurst Medical Centers Form Value-Based Care Partnership

Staff Report From Georgia CEO

Friday, July 15th, 2016

In an effort to drive quality and improve health outcomes for its members, WellCare of Georgia, a subsidiary of WellCare Health Plans, Inc. formed a new value-based care partnership with Oakhurst Medical Centers.

Under the partnership, WellCare of Georgia will collaborate with Oakhurst health care providers to drive quality-based improvements in certain Healthcare Effectiveness Data and Information Set measures, a tool used by more than 90 percent of America's health plans to measure performance on important dimensions of care and service. The partnership will also focus on quality and performance measures set by the Centers for Medicare and Medicaid Services' five-star quality rating system, which assesses Medicare beneficiaries' experience with their health plans and the health care system.

"Quality-based reimbursements represent the standard of care and collaboration between managed care organizations and providers," said Roman Kulich, region president, WellCare of Georgia and South Carolina. "Our partnership with Oakhurst Medical Centers aims to deliver quality care in an effort to improve and sustain positive health outcomes for our members."

Oakhurst, which is a federally qualified health center with four locations in metro Atlanta, provides comprehensive primary and preventive care including prenatal, obstetrics, pediatrics, gynecology, internal medicine, mental health and eldercare. Oakhurst health care providers currently manage care for approximately 3,500 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 health insurance status or ability to pay for services. FQHCs are a critical part of the health care safety net.

"We are excited to enter into value-based contracting with WellCare," said Jeff Taylor, CEO, Oakhurst Medical Centers. "Working together to deliver high quality care in an efficient manner, positions us for success in our communities."