Aledade primary care partners demonstrate how prevention-focused value-based care helps save lives

BETHESDA, Md.: Aledade PBC, a physician-led, national leader in value-based care, today announced that more than 180 of its primary care practice and community health center partners have been recognized by the American Heart Association for their commitment to controlling hypertension through the Target: BP™ initiative.1

“Behind every one of these achievements is a care team that made blood pressure control a priority, not an afterthought,” said Sashi Moodley, MD, chief medical officer at Aledade. “When practices consistently get patients to their goal, they help prevent strokes, heart attacks and heart failure. We're proud to support our partner practices with the value-based care tools and resources they need to keep patients healthy. Controlling blood pressure is one of the clearest examples of that work.”

Value-based care rewards primary care teams for keeping patients healthy, which makes preventing complications such as heart attack and stroke a daily priority. In 2024, 93% of Aledade accountable care organizations (ACOs) achieved shared savings in the Medicare Shared Savings Program (MSSP), compared with 73% of non-Aledade ACOs.² Aledade partners also helped patients avoid more than 171,000 hospitalizations and emergency department visits.³ Central to this success is helping Medicare patients manage chronic conditions such as hypertension. In 2024, Aledade’s blood pressure control rate was 83%, approximately 30% higher than the national control rate.⁴˒⁵

The Target: BP™ initiative, launched in 2015, recognizes healthcare organizations that achieve blood pressure control rates of 70% or greater among their adult patient population. According to the Centers for Disease Control and Prevention, more than 48% of U.S. adults, or 119.9 million people, have hypertension, which increases the risk for heart disease and stroke, among the leading causes of death in the United States.

This year’s honorees, like Brevard Health Center, an independent primary care practice in Florida and Hyndman Area Health Center, a federally qualified health center (FQHC) in Pennsylvania, achieve these exceptional results through a multi-layered approach.

Aledade provides partner practices with AI-enabled data dashboards, expert hypertension consulting, local team support and targeted outreach to help patients reach their blood pressure goals. This clinical strategy is built on Aledade's Core 4 care model, the playbook that helps primary care teams reach the right patients at the right moment. For blood pressure, that means:

• Access & Quality: Identifying patients with hypertension who are overdue for a visit or a reading, so no one slips through the cracks.
• Point of Care: Showing the care team a patient's latest reading and control status during the visit, so uncontrolled pressure is addressed on the spot.
• Care Compass: Connecting patients to clinical services, such as hypertension consulting, that matches their needs.
• Care Transitions: Following up after a hospital, ED or skilled nursing stay, so blood pressure care doesn't lapse at home.

To help partner practices and health centers turn priorities into patient results, Aledade guides care teams through the Four Ms framework: Measure, Manage, Monitor and Motivate, the clinical approach behind blood pressure control. This strategy aligns the entire care team by coordinating clinical staff to assess and treat patients while equipping administrative teams to drive consistent follow-ups, ensuring everyone is empowered to support ongoing patient health.

Aledade community health centers deliver blood pressure control for patients with complex needs. More than half of the recognized Aledade partners are FQHCs or community health centers, which serve medically under-resourced areas and provide primary care regardless of a patient’s ability to pay. Aledade’s Community Health Center Center of Excellence connects health centers nationwide to share the practices that help patients reach their blood pressure goals.

Frequently asked questions about the Target: BP™ initiative and value-based care:

1. What is the Target: BP™ initiative and what is the criteria for recognition?

Target: BP™ recognizes healthcare organizations that commit to:

• Improving blood pressure control
• Employing evidence-based practices
• Achieving blood pressure control rates of 70% or more with the patients they serve

2. How does Aledade support its partner practices and community health centers to succeed in value-based care?

Aledade uses its Core 4 care model to help primary care organizations deliver high-quality, preventive care. The framework guides practices to proactively identify patients needing care (Access & Quality), act on critical health insights during patient visits (Point of Care), connect patients to tailored clinical services (Care Compass) and ensure patients remain supported after leaving a hospital or care facility (Care Transitions).

3. Why is blood pressure control critical to success in accountable care organizations (ACOs)?

Blood pressure control is a key driver of cardiovascular disease prevention. Catching and managing hypertension early helps patients avoid heart attacks, strokes and hospital stays, which improves quality of care and helps ACOs succeed in value-based care.

4. How do primary care practices achieve 70%+ blood pressure control rates?

Primary care practices achieve 70%+ blood pressure control rates by making it a team priority and using the right support. Aledade guides care teams through a "Four Ms" framework: Measure, Manage, Monitor and Motivate. This strategy aligns the entire care team by coordinating clinical staff to assess and treat patients while equipping administrative teams to drive consistent follow-ups, ensuring everyone is empowered to support ongoing patient health.

Citations

About Aledade PBC

Aledade is a physician-led public benefit corporation and national leader in value-based care. We help primary care organizations deliver better patient outcomes and thrive financially by keeping people healthy. Through our accountable care organizations, over 3,000 primary care partners in 46 states and the District of Columbia share in the rewards of improved care for over 3 million patients - supported by advanced insights, AI-driven technology, personal coaching, policy expertise and 270+ value-based contracts. Learn more at www.aledade.com or follow us on LinkedIn, X, Facebook, Instagram and YouTube.

Fonte: Business Wire