Study: UnitedHealthcare Report Details Value-Based Care Successes

March 13, 2018
ACOs serving employer-sponsored plan participants perform better than non-ACOs on 87 percent of quality metrics that were tracked in UnitedHealthcare’s second annual value-based care report.

Accountable care organizations (ACOs) serving employer-sponsored plan participants perform better than non-ACOs on 87 percent of quality metrics that were tracked in UnitedHealthcare’s second annual value-based care report.

The report details how placing greater emphasis on value in healthcare is proving successful for everyone who touches the healthcare system by using incentives to reward better health and lower costs. The data in the report from the Minnesota-based payer is based on the 110,000 physicians and 1,100 hospitals engaged in a value-based relationship with UnitedHealthcare, and the 15 million UnitedHealthcare plan participants who sought care from those providers in 2017.

By comparing this sizable population to patients who seek care from care providers not participating in any form of value-based reimbursement, “clear patterns have begun to emerge illustrating the benefit of enhanced care coordination, placing greater emphasis on keeping people healthy and rewarding care providers for lowering the total cost of care,” according to the organization’s officials.

The report revealed that UnitedHealthcare and care providers in value-based relationships worked together to identify and close 50 million gaps in care from 2013 through 2017. And, hospital admission rates were found to be 17-percent percent lower for ACOs serving employer-sponsored and individual plan participants compared to non-ACOs.

The analysis also found that care providers are expanding the amount and type of compensation that is tied to value-based measures. Among Medicare ACOs working with UnitedHealthcare, over the last year 20 percent have moved further along the risk continuum, which means they are sharing a greater portion of the responsibility for patients’ total care, including quality and healthcare costs.

Today, approximately $64 billion of the total annual payments UnitedHealthcare makes to care providers is tied to value-based arrangements, and the company continues to expect that to rise to $75 billion by the end of 2020, officials noted.

“Value-based care is creating a platform for positive change throughout the healthcare system,” Sam Ho, M.D., chief medical officer of UnitedHealthcare, said in a statement. “Patients get more consistent, quality care that is better coordinated and easier to navigate; health plans and care providers are working together on behalf of patients in new ways; and physicians are being rewarded for placing value and quality over volume.”

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