Aetna Better Health of Illinois Invests $20.4 Million to Strengthen Value-Based Care and Improve Health Equity Across the State
Aetna Better Health® of Illinois, a Medicaid managed care plan and subsidiary of CVS Health® (NYSE: CVS), has made a landmark investment of $20.4 million in incentive payments to community health centers across Illinois. The initiative, which centers on value-based care partnerships, is aimed at enhancing the quality, accessibility, and coordination of healthcare in under-resourced communities.
The funding is part of Aetna’s broader commitment to transforming how healthcare is delivered, emphasizing proactive, patient-centered care that prevents unnecessary hospitalizations and emergency department visits. By supporting a diverse network of providers who are aligned on value-based goals, Aetna Better Health of Illinois is not only addressing disparities in healthcare access and outcomes but also helping to build a more sustainable healthcare system throughout the state.
Advancing Value-Based Care Across Illinois
The $20.4 million in funding represents incentive payments distributed to several provider organizations that have demonstrated success in implementing value-based care models. Unlike traditional fee-for-service arrangements that reward volume over value, these models prioritize measurable outcomes, care coordination, and population health management.
“Developing collaborative, value-based provider relationships has helped enable our members to receive timely and appropriate care, which has led to healthier lives and a more sustainable health care system,” said 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, more than half—56%—of Aetna Better Health of Illinois’ Medicaid members receive care through providers engaged in value-based care agreements. Notably, 23% of those providers participate in advanced risk-based models. These models tie provider reimbursement more directly to clinical outcomes and total cost of care, creating powerful incentives for innovation and accountability in care delivery.
Tangible Outcomes for Medicaid Members
The shift toward value-based care has already shown promising results. Aetna Better Health of Illinois reported significant improvements in several key health utilization metrics among its Medicaid population in 2024:
- An 8.2% reduction in inpatient admissions
- A 14.9% decrease in inpatient readmissions
- A 4.8% drop in emergency room visits per 1,000 members
These figures underscore the positive impact of aligning provider incentives with preventive care and chronic disease management. Timely access to primary and behavioral health services can prevent the progression of illness and reduce the likelihood of costly, disruptive hospital visits. Moreover, fewer emergency department visits free up resources and allow patients to maintain continuity in their daily lives.
A Customized Support Model for Providers
One of the distinguishing features of Aetna’s approach is its tailored support model for participating providers. Recognizing that each community health center has unique needs and challenges, Aetna Better Health of Illinois provides data-driven guidance, clinical resources, and operational support customized by provider type, geography, and performance benchmarks.
This comprehensive support model includes:
- Detailed analyses of clinical, financial, and operational benchmarks
- Recommendations for targeted interventions with at-risk members
- Onsite case management services
- Deployment of rural health workers to expand care access in underserved regions
- Ongoing data analysis to identify high-risk members with frequent hospitalizations
- Training programs to help providers interpret data reports and integrate them into clinical workflows
The goal is to equip providers not only with the tools to succeed under value-based arrangements but also to overcome resource limitations and administrative barriers that have historically hindered care transformation.
Participating Health Centers: A Statewide Commitment to Equity
A total of 16 provider organizations received value-based incentive payments through the initiative. These health centers serve some of Illinois’ most vulnerable populations and are using the funds to expand access, invest in data analytics infrastructure, and extend clinic hours to better meet community needs.
The recipients include:
- Access Community Health Network
- Apogee Health Partners
- Aunt Martha’s Health and Wellness
- Community Health Care, Inc.
- Crusader Community Health
- Family Christian Health Center
- Family Medicine Specialists
- Illinois Health Practice Alliance
- Lawndale Christian Health Center
- Memorial Health Partners
- UnityPoint Health
- PCC Community Wellness
- Primary Care Joliet
- Progress Health
- Swedish Covenant
- VNA Health Care
These centers are already channeling their funds into modernization efforts—whether through implementing new population health management platforms, upgrading electronic health record systems, or expanding integrated care models that address both medical and social needs.
Voices from the Frontlines: Community Providers Reflect on Impact
For many of the participating providers, the value-based care initiative reaffirms their long-standing commitment to integrated, team-based care.
“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 of 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.”
Other health centers echoed these sentiments. Abby Boyer, Vice President of Population Health Strategy and Quality at Access Community Health Network, emphasized the organizational culture shift made possible by the funding.
“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,” Boyer explained. “This teamwork ensures holistic care that addresses all aspects of a patient’s well-being and leads to better health and well-being.”
Karen Janousek, Vice President and Chief Population Health Growth Officer of Sinai Chicago—Progress Health’s parent system—highlighted the importance of addressing broader social determinants of health (SDOH) alongside medical care.
“Our collaboration with Aetna Better Health of Illinois solidifies our commitment to providing integrated and holistic care,” said Janousek. “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’s Continued Mission in Illinois
Serving over 360,000 Medicaid beneficiaries across 102 counties, Aetna Better Health of Illinois plays a central role in the state’s healthcare ecosystem. Through its emphasis on value-based partnerships, the health plan continues to introduce best practices that improve utilization rates, close care gaps, and drive higher levels of member satisfaction.
With this latest $20.4 million investment, Aetna is not only recognizing the work of community health providers but also reinforcing its belief in local partnerships as a vehicle for health system transformation.
As healthcare delivery continues to evolve, the collaborative model demonstrated by Aetna Better Health of Illinois and its provider partners offers a compelling blueprint for how Medicaid managed care organizations can improve population health while reducing systemic costs.
Ultimately, by investing in the providers that serve on the frontlines of care and empowering them with data, tools, and financial resources, Aetna is helping to ensure that more Illinois residents—regardless of zip code—have access to the quality care they need and deserve.
