Houston, Texas - February 20, 2025 – CareAllies contributed data to a newly released study that is among the first to indicate superior results for patients managed by physicians who participate in risk-based payment arrangements, instead of traditional fee-for-service reimbursement. Published in JAMA Network Open™, the study analyzed care provided to more than one million Medicare Advantage (MA) patients by 17 member organizations of America’s Physician Groups (APG) over three years.
“This important study confirms what we at CareAllies have known for quite some time: that risk-based arrangements, where whole-person care is prioritized and the provider is accountable for care, work,” said Rob Cetti, CareAllies President and APG board member. “It shows that physicians in these contracts hold the key to improving patient care and reducing costs. This is because physicians who participate in risk arrangements have the flexibility to give their patients the most appropriate support services.”
The research compared patient care delivered under at-risk MA payment arrangements to care delivered under fee-for-service MA payment arrangements within the same physician practices. Results showed that when physicians accepted risk-based payment models, patients were:
- 8.7 percent less likely to have a hospital admission
- 8-22 percent less likely to be admitted to a hospital for common chronic conditions such as diabetes, high blood pressure, chronic obstructive pulmonary disease (COPD), and heart failure
- 10.7 percent less likely to experience an avoidable emergency department visit
- 8.7 percent less likely to be admitted to a hospital from an emergency department
- 15 percent less likely to use high-risk medications that can cause serious adverse effects or death if used incorrectly or in combination with other medications
“Physicians in risk-based arrangements can care for their patients better than anyone else because they have the full autonomy to make decisions about patient care. This study proves the value in moving to these models,” agreed Dr. Joe Nicholson, CareAllies Chief Medical Officer and APG board member. “They can align more staff and resources towards activities such as team-based care for patients with chronic conditions, care coordination, funding patient-centered programs needed in their community, and patient outreach—many of the services our Value-Based Care Nurses provide every day,” he added.
“APG is a national organization representing physician groups committed to value-based health care. Our members care for about one of every three MA patients nationwide,” said APG President and Chief Executive Officer Susan Dentzer. “This study illustrates not only the results of their leading-edge care, but also the positive impact that’s possible when physician groups and MA plans embrace close partnerships and accountability for care.”
Full text and details of the study can be found in the Jan. 23, 2025, edition of JAMA Network Open. APG has also released an infographic and press release describing key points about the research.
About CareAllies
Ranked the number one value-based care solution for physician organizations from 2018-2024 by Black Book Market Research, CareAllies has almost 25 years of experience in providing management services -- and the people, processes, and technology -- that physician organizations need to succeed in value-based care. CareAllies simplifies the journey to more rewarding health care by alleviating administrative burdens while giving physicians and staff the information they need to better manage their patient populations. CareAllies aggregates and analyzes data, delivers actionable reports and decision-support tools within existing workflows, and deploys business and clinical support teams to enhance operations, align incentives, and improve care coordination. Collaborating with CareAllies helps physicians deliver more accessible and affordable care while allowing them to focus on their most rewarding endeavor: improving patient health outcomes. To learn more about CareAllies, including links to follow them on Facebook, LinkedIn, or YouTube, visit www.careallies.com.
About America’s Physician Groups
APG’s approximately 360 physician groups comprise 170,000 physicians, as well as thousands of other clinicians, providing care to nearly 90 million patients, including about 1 in 3 Medicare Advantage enrollees. APG’s motto, ‘Taking Responsibility for America’s Health,’ represents our members’ commitment to clinically integrated, coordinated, value-based health care in which physician groups are accountable for the costs and quality of patient care. Visit us at www.apg.org.