AmeriHealth Caritas Ohio and Zest Pediatric Network Launch Value-based Program to Improve Child Health
July 10, 2024 - Dublin, Ohio
AmeriHealth Caritas Ohio’s youngest members in northeast Ohio can now receive more personalized care quicker than before at no additional cost to their families.
The Medicaid health plan is teaming up with Zest Pediatric Network to test a new value-based payment model that will utilize concierge-style pediatric care for Medicaid members in the Cleveland area.
Transportation, work schedules, and childcare arrangements are some of the factors that lead to skipped annual check-ups and unaddressed chronic health conditions. The new program not only helps overcome these challenges by offering participating AmeriHealth Caritas Ohio members easier access to medical care, same-day appointments, virtual appointments, and the ability to call or text doctors directly, but also does so without the out-of-pocket fees and membership costs traditionally associated with this care model.
“We want to eliminate barriers that all too often impede preventive care or divert sick care to emergency departments,” said Mark Grippi, AmeriHealth Caritas Ohio CEO and market president. “This program is special because we are taking the concept of concierge care — that often comes with significant costs to patients — and making it available to Ohioans who need it most.”
“Zest is thrilled to work with AmeriHealth Caritas Ohio to bring this service to underserved Ohio families. Our pediatricians created a program that is designed for parents and caregivers, eliminating many of the challenges that can happen with the traditional doctor office system,” said Andrew Hertz, MD, president and co-founder of Zest Pediatric Network. “Preventive services like well visits can help keep Ohio’s children on track for healthier lives.”
Too many kids in Ohio are not getting the wellness checks and screenings they need. According to Ohio Department of Medicaid (ODM), more than 40 percent of infants and 30 percent of kids ages 3-6 are missing their annual well visits.
Value-based payment (VBP) models promote a higher, more reliable level of care by holding physicians, clinicians, and care facilities accountable for quality and cost through shared financial risk. This VBP incentivizes Zest to provide more preventive, diagnostic, and treatment services; injections, immunizations, and medications; health education and counseling services; and routine screenings for its AmeriHealth Caritas Ohio patients. Through the arrangement, AmeriHealth Caritas Ohio aims to increase access to medical care for underserved children, increasing health outcomes in early childhood and well into the future.
