Waymark announced in April 2024 a new value-based partnership with Sentara Health Plans, the health plan division of Sentara Health, aimed at transforming care delivery for Medicaid members. The collaboration will leverage Waymark's advanced data science technologies and community-based care teams to improve outcomes for Sentara Health Plans' Medicaid members in Hampton Roads and Richmond.
Waymark's local teams of community health workers (CHWs), clinical pharmacists, pharmacy technicians, licensed behavioral health therapists, and care coordinators will integrate with Sentara Health Plans' existing primary care network. Waymark's care teams will identify and engage members at rising risk of avoidable emergency department (ED) visits and hospitalizations, providing them with targeted clinical and social interventions. A 2024 study published in NEJM Catalyst found that Waymark's early interventions reduced all-cause hospital and ED visits by 22.9% for rising-risk patients in its first year of service.
"Our collaboration with Sentara Health Plans builds on our existing support for Virginia's Medicaid population and represents a significant step forward in our mission to make better health possible for those who need it most," said Dr. Rajaie Batniji, Co-Founder and CEO of Waymark. "By combining data-driven early interventions with a multidisciplinary care team, we are expanding provider capacity, reducing disparities and ultimately creating more equitable systems of care for Medicaid members in communities across Virginia."
Waymark will offer Sentara Health Plans Medicaid members proactive preventative care, and when needed, schedule and accompany patients to primary care physicians (PCP) appointments to reduce avoidable hospitalizations and ED visits. By streamlining care coordination and social services referral processes, Waymark will aim to reduce paperwork (social services and prior authorizations) for Sentara's PCPs. Their community-based teams will work to prevent avoidable disease complications and acute care utilization that negatively impact both patient health and costs.
"We're committed to advancing value-based payment models to reduce costs and improve access and quality of care for our Medicaid members," Robert Krebbs, Vice President of Network Management and Value-Based Care for Sentara Health Plans. "Waymark's technology and community-based teams will create additional capacity to support members outside of clinical settings, better address their social needs, and ultimately create healthier communities in Virginia."
The program will initially focus on serving Medicaid members in the Richmond and Hampton Roads areas, with plans to expand to additional regions across Virginia in the future.
Waymark has managed care for 35,000 Medicaid members in Virginia since launching in January 2023. The company enters into risk-based contracts with Medicaid Managed Care Organizations (MCO) to deliver community-based care for their rising-risk populations and transition primary care practices to value-based arrangements. By building a new community health workforce to support PCPs-paid for through value-based arrangements with MCOs-Waymark seeks to increase the capacity of our healthcare delivery system and align payment incentives to enable whole-person care.
