UnitedHealthcare announced that it will nearly double the amount of accountable care organizations it is contracted with in 2015 as it expects to add another 250 ACOs.
UnitedHealthcare announced that it will nearly double the amount of accountable care organizations (ACOs) it is contracted with in 2015 as it expects to add another 250 ACOs.
A total of 11 million plan participants are now enrolled in UnitedHealthcare’s value-based payments through its more than 520 currently active ACOs.
“Working with care providers to ensure they have the right support and incentives will help connect the people we serve to the most effective care, place a greater focus on the quality of their care, and compensate providers for improving patients’ health,” Dan Rosenthal, president of UnitedHealthcare Networks, said in a statement.
According to UnitedHealthcare, in the last 3 years, its total payments to physicians and hospitals that are tied to value-based arrangements nearly tripled to $36 billion. The company estimates that payments will reach $43 billion this year—a 20% increase—and $65 million by the end of 2018.
Among the existing ACOs, UnitedHealthcare has seen a 21% increase in primary care visits from Medicaid members and a 14% decrease in 30-day hospital readmissions. Plus, hospital admissions and emergency room admissions among individual and employer-sponsored plan participants are down 11% and 8%, respectively.
The value-based care UnitedHealthcare is offering through its ACOs takes many forms, such as performance-based contracting and bundled payments for treating specific illnesses, and primary care bonuses and fully integrated population health.
UnitedHealthcare’s announcement to nearly double its ACO contracts comes just weeks after HHS announced that it would tie 50% of traditional Medicare payments to quality or value through models like ACOs or bundled payments by the end of 2018. HHS estimated that existing ACO programs have saved Medicare $417 million and only 20% of payments are currently made through such alternative payment models.
“Deeper, more integrated relationships with health plans like UnitedHealthcare are making a tangible impact on patients’ health,” said Simeon Schwartz, MD, president and chief executive officer of WESTMED.
ACOs’ Focus on Rooting Out Fraud Aligns With CMS Vision Under Oz
April 23rd 2025Accountable care organizations (ACOs) are increasingly playing the role of data sleuths as they identify and report trends of anomalous billing in hopes of salvaging their shared savings. This mission dovetails with that of CMS, which under the new administration plans to prioritize rooting out fraud, waste, and abuse.
Read More
Examining Low-Value Cancer Care Trends Amidst the COVID-19 Pandemic
April 25th 2024On this episode of Managed Care Cast, we're talking with the authors of a study published in the April 2024 issue of The American Journal of Managed Care® about their findings on the rates of low-value cancer care services throughout the COVID-19 pandemic.
Listen
Managed Care Reflections: A Q&A With Hoangmai H. Pham, MD, MPH
April 1st 2025To mark the 30th anniversary of The American Journal of Managed Care® (AJMC®), each issue in 2025 will include a special feature: reflections from a thought leader on what has changed—and what has not—over the past 3 decades and what’s next for managed care. The April issue features a conversation with Hoangmai H. Pham, MD, MPH, a member of AJMC’s editorial board and the president and CEO of the Institute for Exceptional Care (IEC).
Read More