UnitedHealthcare bets big on ACOs

By BenefitsPro


By Kathryn Mayer

UnitedHealthcare said Wednesday it expects to more than double its accountable care contracts over the next five years, from $20 billion to $50 billion.

The nation’s largest health insurance company said the move will help transform how health care is delivered, paid for and rewarded.

Under the ACO model — which brings together groups of hospitals, doctors and other health providers to direct patient care — organizations are paid for caring for a pool of patients rather than for each procedure. Groups receive a percentage of the savings they generate for Medicare as an incentive for keeping costs low.

The initiative is a critical component of the Patient Protection and Affordable Care Act.

Already, UnitedHealth said it has accountable care relationships with more than 575 hospitals, 1,100 medical groups and 75,000 physicians across the country. More than $20 billion of the carrier’s reimbursements to hospitals, physicians and ancillary care providers are paid through contracts that link a portion of the reimbursement to quality and cost-efficiency measures.

“We are improving health outcomes for patients at lower costs by moving even more broadly to value-based payment models and integrating those with our care provider network, product and clinical strategies,” Austin Pittman, president of UnitedHealthcare Networks, said in a statement. “Our unparalleled experience with accountable care models — and there are many — demonstrates that they can work better for everyone in health care, from patients to payers to care providers.”

ACOs have been increasingly popular, and other insurers have stated their plans to link with them. But UnitedHealth’s announcement is different in that they place an actual — and large — dollar figure on their plans.

Physicians also have been flocking toward the new model.

According to a recent Medscape survey, nearly one in four doctors are in or planning to link with an accountable care organization within a year.

Many have said ACOs are necessary to curb an unsustainable rise in health care costs.

“Physicians have increasingly decided that the current fee-for-service model is not sustainable in the long term, but they want payment models that are more customized to meet their specific needs,” Ruth Benton, chief executive officer of New West Physicians of Denver, said in UnitedHealth's statement. “UnitedHealthcare has worked with us closely to create a model that provides financial incentives and infrastructure support for delivering evidence-based high-quality care.”

Originally published on BenefitsPro.com