DESIGNING VALUE-BASED MODELS
Florida Blue and Nemours Children’s Health Value Success
As we look to align the value of health and payment, it is critical to demonstrate how health care organizations can successfully transition from fee-for-service to pay-for-health models.
We had the opportunity to pilot a value-based model among 6,500 pediatric patients insured by Florida Blue. In our first year of the new collaboration, we were able to increase, immunizations, preventative screenings, and wellness visits, all while reducing costs for care and medications.
To accomplish this, our primary care providers focused on addressing gaps in care such as wellness visits, immunizations, and other preventative screenings. These initiatives have proven to reduce emergency room visits, while increasing quality of health outcomes.
15.7%
in preventative care
24% decrease
in hospital readmission rates vs. a 5.6% increase among similar providers during the same timeframe
15% reduction
in use of brand-name medications
$300,000
in shared cost savings
These results show that access to care and improving care management for kids and families works. We will continue to pursue opportunities to replicate the success of this program with larger populations of Florida’s children.
