March 20, 2024  – In a strategic move, Wellcare, a Medicare brand under Centene Corporation, announced a groundbreaking partnership with Pearl Health, a leading technology firm specializing in physician enablement and risk bearing in value-based care contracts. This multi-year Medicare Advantage partnership is designed to increase financial risk sharing and leverage advanced care models to benefit Medicare Advantage beneficiaries.

Pearl Health will provide Wellcare’s network of primary care providers with unparalleled access to crucial data insights, financial tools, and practice enablement technologies. This collaboration aims to empower Wellcare and its affiliated providers to deliver more proactive, holistic patient care, simultaneously elevating care quality and driving down healthcare costs.

Currently operational in South Carolina, this program harbors ambitions of national expansion, with the partnership between Wellcare and Pearl Health serving as a catalyst for broader adoption of value-based care practices. The synergy of Pearl Health’s technological expertise and Wellcare’s vast network is expected to support primary care physicians in transitioning from traditional fee-for-service models to more sustainable, outcome-focused value-based care arrangements.

Michael Carson, Centene’s Medicare Chief Executive Officer, expressed enthusiasm about the partnership, stating, “We are pleased to deploy a value-based partnership with Pearl as we work together to improve quality and clinical outcomes for our diverse and complex Medicare Advantage members. We look forward to success as we work collaboratively in South Carolina for Medicare Advantage members.”

As the healthcare industry continues to pivot towards value-based care, collaborations such as the one between Wellcare and Pearl Health underscore the growing trend of healthcare entities seeking external expertise and technology solutions to thrive in value-based contracts. Similar initiatives, like CareFirst BlueCross BlueShield’s partnership with Aledade, have demonstrated the effectiveness of leveraging external resources to equip primary care physicians with the necessary tools for success in value-based care environments.

By aligning value-based care objectives across various stakeholders, including payers, providers, and technology partners, such partnerships are instrumental in ensuring members receive higher quality care at lower costs. The Wellcare and Pearl Health collaboration represents a significant step forward in the ongoing transformation of healthcare delivery, promising enhanced care outcomes for Medicare Advantage beneficiaries through innovative risk-sharing and care management strategies.