DOWNERS GROVE, Ill., May 20, 2025 — Aetna Better Health® of Illinois, a CVS Health® company (NYSE: CVS), delivered $20.4 million in value-based care incentive payments to several community health centers in Illinois. The funds will help the centers improve quality of care in under-resourced communities.
“Developing collaborative, value-based provider relationships have helped enable our members to receive timely and appropriate care, which has led to healthier lives and a more sustainable health care system,” stated Rushil Desai, CEO of Aetna Better Health of Illinois. “This collective effort has not only improved member quality outcomes but has also reduced avoidable hospitalizations. We look forward to continuing to build a network of providers that prioritizes high-quality, patient-centered care.”
Currently, 56% of Aetna Better Health of Illinois members see Aetna providers who are engaged in value-based care agreements, with 23% operating on a risk-based model, which incentivizes providers the most to transform how they deliver care to their patients. These value-based care collaborations with providers are helping members achieve better health outcomes, including 8.2% fewer inpatient admissions, 14.9% fewer inpatient re-admissions, and 4.8% fewer emergency room visits per 1,000 members in 2024. When members receive timely, patient-centered, high-quality primary care, they often can avoid unnecessary hospitalizations and emergency room visits, which can be costly for members and take time away from their daily lives.
To promote success in value-based care, Aetna Better Health of Illinois deploys a proactive support model customized by provider type, location and performance. The health plan gives providers detailed analyses of core clinical, financial and operational benchmarks, offering visibility and recommendations for intervention with patients.
In addition, the health plan enhances provider capabilities by creating tailored strategies to address resource limitations and administrative barriers. Support models may include onsite case management, access to rural health workers, ongoing data analysis to identify frequently hospitalized members for provider intervention and staff training on reports for workflow integration.
Providers engaged in the value-based care arrangement that received funds were:
Access Community Health Network
Apogee Health Partners
Aunt Martha’s Health and Wellness
Community Health Care, Inc
Crusader Community Health
Family Christian Health
Family Medicine Specialists
Illinois Health Practice Alliance
Lawndale Family Christian
Memorial Health Partners
Unity Point Health
PCC Community Wellness
Primary Care Joliet
Progress Health
Swedish Covenant
VNA Health Care
The health centers are using the funds primarily to modernize their operational processes, implement new population health or data analytics tools and extend clinic hours to better serve their community.
“Aunt Martha’s built its care model around integration more than two decades ago, embedding behavioral health into primary care, because we saw the difference it made,” said Raul Garza, President and CEO, Aunt Martha’s Health and Wellness. “That approach is now the foundation of value-based care. Our collaboration with Aetna Better Health of Illinois validates what we’ve long believed: integrated systems deliver better outcomes, reduce costs and provide real value to the communities we serve.”
“The value-based care agreement has given us the ability to foster a team-based approach within our organization, promoting collaboration across various disciplines such as primary care providers, quality improvement specialists and care coordinators,” said Abby Boyer, Vice President of Population Health Strategy and Quality of Access Community Health Network. “This teamwork ensures holistic care that addresses all aspects of a patient’s well-being and leads to better health and well-being.”
“Our collaboration with Aetna Better Health of Illinois solidifies our commitment to providing integrated and holistic care,” said Karen Janousek, Vice President and Chief Population Health Growth Officer of Sinai Chicago, the health system affiliate of Progress Health. “The funding allows us to implement tailored strategies that address not only medical needs but also social determinants of health, ensuring that our patients receive the comprehensive care they deserve.”
Aetna Better Health of Illinois serves over 360,000 Medicaid members in 102 counties. The health plan offers value-added benefits and best practices that have proven positive results in utilization, health gap closures and member satisfaction. For more information about Aetna Better Health of Illinois, visit our website, www.aetnabetterhealth.com/illinois-medicaid.
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About Aetna Medicaid
Aetna Medicaid Administrators LLC (Aetna Medicaid), a CVS Health company, has over 30 years of experience managing the care of under-resourced populations, using innovative approaches and a local presence in each market to achieve both successful health care results and effective cost outcomes. Aetna Medicaid has expertise serving high-need Medicaid members, including those who are dually eligible for Medicaid and Medicare. Currently, Aetna Medicaid owns and/or administers Medicaid managed health care plans under the names of Aetna Better Health and other affiliate names. Together, these plans serve members in 15 states, including Arizona, Florida, Illinois, Kentucky, Louisiana, Maryland, Michigan, New Jersey, New York, Ohio, Oklahoma, Pennsylvania, Texas, Virginia and West Virginia. For more information, see www.aetnabetterhealth.com.
About CVS Health
CVS Health® is a leading health solutions company building a world of health around every consumer, wherever they are. As of December 31, 2024, the Company had more than 9,000 retail pharmacy locations, more than 1,000 walk-in and primary care medical clinics, a leading pharmacy benefits manager with approximately 90 million plan members, and a dedicated senior pharmacy care business serving more than 800,000 patients per year. The Company also serves an estimated more than 36 million people through traditional, voluntary and consumer-directed health insurance products and related services, including highly rated Medicare Advantage offerings and a leading standalone Medicare Part D prescription drug plan. The Company’s integrated model uses personalized, technology driven services to connect people to simply better health, increasing access to quality care, delivering better outcomes, and lowering overall costs.
Media contact
Monica PrinzingMonica.Prinzing@CVSHealth.com
