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UnitedHealthcare enrolls 11 million in accountable care programs


More than 11 million UnitedHealthcare members are enrolled in accountable care organizations (ACOs), and the nation's top insurer plans to contract with 250 more ACOs in 2015.

In an effort to compensate providers based on the quality of care, UnitedHealthcare has shifted 11 million individual, employer-sponsored, Medicare and Medicaid plan participants into value-based programs.

The nation’s largest insurer currently contracts with about 520 accountable care organizations (ACOs), and it has announced plans to contract with 250 new ACOs in 2015.

“These deeper, more collaborative relationships” with hospitals, physicians and providers will help UnitedHealthcare realize its goal of increasing the value and quality of care provided to their customers, the company said in a press release.

Related:Top stakeholders form task force to accelerate shift to value-based care

“UnitedHealthcare is building more collaborative relationships with more care providers to ensure our plan participants have access to higher-quality, cost-effective care,” said Dan Rosenthal, president of UnitedHealthcare Networks.

Care providers seem receptive to UnitedHealthcare’s mission: The insurer has nearly tripled the payments to physicians and hospitals tied to value-based care initiatives. In 2015, those payments are expected to increase by 20% to $43 billion and, by 2018, payments are expected to reach $65 billion.

Instead of focusing on isolated individual health problems, providers are given additional support to manage population health, according to the insurer. Support from UnitedHealthcare includes IT tools that can lower costs and provide immediate, actionable data, according to the company.

Its current ACOs are improving patient health and lowering costs by keeping all aspects of a patient’s healthcare connected and in one place; rewarding physicians that encourage preventative care; and transitioning care providers into a model that pays based on the total value to the patient instead of a model that only rewards “fee-for-service.”

“Deeper, more integrated relationships with health plans like UnitedHealthcare are making a tangible impact on patient’s health,” said Simon Schwartz, M.D., president and chief executive officer of New York-based WESTMED Medical Group, which began an ACO arrangement with UnitedHealthcare in 2012 to serve its 13,000 plan participants.

Related:Plans, providers must collaborate for value-based payment models to succeed


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