Equality Health Brings Proven “Medicaid-First” Value-Based Care Model to Virginia

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Equality Health, a national leader in value-based care, today announced its latest expansion into the Commonwealth of Virginia, offering its proven value-based care (VBC) model to primary care providers (PCPs) and health plans throughout the state. Proudly “Medicaid-first,” Equality Health aims to improve the healthcare experience of the nearly 2 million Medicaid enrollees in Virginia, while also helping participating providers advance their Medicaid, Medicare, Medicare Advantage, Exchange and commercial VBC strategies. With proprietary technology, in-practice coaching, an activity-based financial model, and community-based wraparound member support, Equality Health drives a best-in-class managed care delivery system for improved cost, quality, and health outcomes.

In Virginia and across the U.S., independent PCPs face unprecedented pressure from the compounding demands of traditional fee-for-service (FFS) business models, health plans are being pushed to further integrate care, and members face mounting non-medical barriers to health. Value-based transformation rooted in health equity is essential to move away from the inefficiencies of the FFS system, but implementing these alternative payment models often requires administrative and clinical efforts that can be challenging for independent practices, particularly when contracting with multiple health plans.

Equality Health equips participating PCPs, at no cost, with its CareEmpower® VBC technology, along with additional tools, training and an activity-based financial model necessary to improve health outcomes for vulnerable Medicaid members. Its distinct model simplifies PCP administrative work, while its local support teams help analyze workflow, adopt best practices, and coordinate both clinical and social needs across the continuum. At the same time, Equality Health supports health plans’ quality initiatives and serves as an extension to their care management teams in the community.

According to a June 2023 online report from independent resource, KKF.org, more than 2 million of the total 8.6 million Virginia residents – 23 percent – are currently covered by Medicaid; 30% of Medicaid beneficiaries are children and 58% of non-elderly enrollees are people of color.

“We’re here to help address health inequities by collaborating with PCPs and health plans in under-resourced communities so they can be successful in value-based care,” said Hugh Lytle, Equality Health founder and CEO. “Navigating the complexities of alternative payment models can be daunting – especially for small practices serving historically underserved populations, like Medicaid beneficiaries. By enabling PCPs with additional technology and support, we can make a dramatic difference in the health of our communities.” 

Virginia-based PCPs interested in learning more about how they can help address healthcare inequities and reap the benefits of joining Equality Health’s Network can visit this website. Health plans interested in partnering to enhance provider and member engagement through Equality Health’s comprehensive value-based care model can learn more at the health plan resource page.

This latest expansion news follows Equality Health’s August 2023 announced entry into Louisiana, as well as its recently expanded Equality Health at Home care program – an innovative initiative through which a culturally competent team including community health workers, nurse practitioners and chaplains partner with network PCPs to support medically complex members unable to receive care in traditional primary care settings.

Alongside the expansion, the Equality Health Foundation will bring its community-based health and well-being programs into Virginia — including health fairs and food-distribution events — to advance health equity among diverse and underserved communities in the state.

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