Gateway Health Plan, Inc., (“Gateway Health”), a leading managed care organization dedicated to caring for the total health of its members, and WellSpan Health (“WellSpan”), a leading non-profit health system in South Central Pennsylvania committed to exceptional care for all, today announced that they have entered into a value-based partnership agreement.
Through this value-based partnership, Gateway Health and WellSpan aim to deliver an enhanced level of care, improve health outcomes, and lower health care costs for Gateway Health’s Medicaid members receiving care at WellSpan’s 200-plus health care locations. This partnership will utilize data insights and value-based programs to proactively manage the health care needs for more than 24,000 Gateway Health Medicaid members living in South Central Pennsylvania.
“At Gateway Health, we believe that truly caring for a person's health requires a different kind of health care,” said Ellen Duffield, Chief Operations Officer, Gateway Health. “Gateway Health is proud to partner with WellSpan to provide our Medicaid members with enhanced value-based care that they can really count on. We are committed to connecting our members to the type of care they need to live healthier lives and achieve not just physical health, but whole life health.”
Gateway Health coordinates health care that goes beyond doctors and medicine to deliver whole person care to the communities it serves. Gateway Health has served the most vulnerable populations across the Commonwealth for nearly 30 years.
For WellSpan, the partnership aligns with the organization’s mission of improving health through exceptional care for all, while keeping affordability at the forefront.
“A key driver in growing our relationship with Gateway Health is learning more about the most effective ways to provide care to patients that promotes lifelong wellness,” said Dr. Geoff Nicholson, Jr., Senior Vice President, Population Health, WellSpan. “Together, we can keep patients healthier and strive for a shared vision of higher quality care at lower costs.”
Together, the organizations are addressing barriers to health care through new approaches using shared data. A key to healthy living is a relationship with a primary care provider to manage chronic conditions, monitor age-appropriate screenings and prevent avoidable hospitalizations. Gateway Health and WellSpan are proactively contacting Gateway Health’s Medicaid members who visit the health system through emergency or urgent care visits, but do not have a relationship with a primary care provider. Case managers then work one-on-one with the individuals to address barriers, such as transportation and cost, to establishing an appropriate primary care relationship. With connections to lifelong care, patients are more likely to avoid costly emergency department visits and maintain healthier lives.
This partnership expands on the existing relationship between Gateway Health and WellSpan. For the past 18 months, they have partnered together for better maternal care and coverage through Foundations Pregnancy Support Services, a program offering coordinated, comprehensive care for women and their children with opioid use disorder. WellSpan partners with other Medicaid insurers to provide this support. However, the commitment and innovative partnership with Gateway Health has resulted in more than double the number of members enrolled than with any other insurer.