In this new role, Mr. Abramson will work alongside executive leadership and UpStream’s partner organizations to develop winning payor strategies that align with health plans and delivery system requirements to ensure market access, improved quality of care and financial strength for UpStream and its network of primary care physicians/integrated health professionals to better serve seniors in Medicare Advantage programs. He will also coordinate across product lines to ensure that vital primary care access is maintained across UpStream’s provider networks.
“I’ve been fortunate in my career to have experience working on both the payor and provider side with local, regional, and national organizations,” said Mr. Abramson. “Joining UpStream, with our focus on supporting primary care physicians with the tools necessary to succeed in value-based care, will allow me to utilize all of these learnings and experiences to the benefit of our provider partners and their patients.”
Most recently, Mr. Abramson oversaw the managed care functions across both UT Southwestern and Texas Health Resources and more than 500 community based primary care physicians, representing more than $6 billion in contracted revenue, with more than 750,000 patients in value-based arrangements. Before joining SWHR, Mr. Abramson was National Vice President, Contracting & Payor Relations for Ascension Health, one of the largest non-profit health systems in the U.S., where he was responsible for fee-for-service and value-based managed care contracting generating approximately $12 billion in revenue.
Mr. Abramson has extensive health plan experience, having served at Oscar Health, a technology-focused health insurance company, leading national delivery partnerships. He previously was Senior Vice President, Strategy & Operations, Aetna Accountable Care Solutions for Aetna Inc., one of the nation’s leading health insurance companies, where he managed some of Aetna’s Accountable Care Organization (ACO) relationships. In his earlier role as Senior Vice President, Business Development, Accountable Care Solutions for Aetna, he led regional initiatives partnering with large health systems, hospitals, and physician organizations to employ technology, tools, and programs to advance ACO development, strategies, and value-based economic models with a focus on joint accountable care insurance product offerings.
“Steve’s work is crucial to the future of our network’s physicians participating in alternate payment models. His attention to the payor environment in a constantly changing field of contracts and regulations allows us to ensure the best possible managed care contracting for our clinical partners and medical groups. With more PCPs in value-based care, we can deliver the highest standard of care for our valued senior patients,” said UpStream CEO, Dr. Sanjay Doddamani. He further explained the UpStream partnered physician groups expect to have access to the embedded clinical teams, unique care model and incentive programs which cannot be implemented unless they shift to value-based care.
“I am delighted to welcome Steve Abramson to UpStream. Steve brings vast experience in value-based contracting and understands both payor and provider concerns and opportunities to be successful in caring for older, sicker patients through payment innovation” explained UpStream’s Founder, Chief Strategy Officer and Board Member, Fergus Hoban, adding, “with the addition of Steve, we have completed building one of the most experienced C-Suite healthcare leadership teams in the country, under Sanjay, and all over the past year!”
UpStream Healthcare’s unique model offers support to practices of any size or historic experience who do not have the resources or ability to take the heavy financial risks currently associated with value-based models. Participating providers receive Guaranteed Advanced Payments for Quality or GAP-Q™ as financial incentives on a schedule basis for their quality performance, taking out guess work in an otherwise unpredictable environment.
About UpStream Healthcare
UpStream Healthcare provides physicians with the support and systems they need to improve their practices, and therefore their patients’ care. To achieve this, we embed a powerful support platform that facilitates physicians, pharmacists, and nurses to work together in primary care practices of all sizes.
SOURCE UpStream Healthcare