ProHealth Physicians, Inc., and UnitedHealthcare have launched an accountable care organization (ACO) to provide enhanced, coordinated care to more than 11,000 Connecticut residents enrolled in UnitedHealthcare’s employer-sponsored health plans, including UnitedHealthcare- and Oxford Health-branded plans.
ProHealth Physicians is a leading multispecialty group practice with more than 350 primary care and specialty providers practicing at nearly 100 locations throughout Connecticut’s eight counties. ProHealth and UnitedHealthcare have been collaborating for the last several years on programs that better integrate and enhance patient care, most recently on several programs to help improve the health of UnitedHealthcare’s Medicare Advantage beneficiaries.
This new ACO will help continue Connecticut’s shift to a health care system that rewards quality and value rather than the volume of procedures performed. ProHealth and its 350 care providers will manage all aspects of patients’ care, providing the right care in the right place at the right time. Physicians will be eligible to receive payment incentives based on evidence-based measures, such as hospital readmission rates, disease management and prevention, patient safety and care delivery, as well as total cost savings and patient satisfaction.
“This partnership further enhances our longstanding relationship with UnitedHealthcare and enables us to better serve our community’s unique health care needs,” said James Cox-Chapman, M.D., ProHealth’s Chief Medical Officer. “With UnitedHealthcare, we continue to increase patient engagement to achieve better health outcomes and improve patient satisfaction, while reducing the overall cost of care.”
UnitedHealthcare employer-sponsored plan participants who currently receive care from ProHealth providers will not have to do anything differently to receive the benefits of this latest collaboration, which include care coordination and follow-up.
“UnitedHealthcare’s collaboration with ProHealth Physicians underscores the deeper relationships the company is building with local care providers to enhance health services and improve the coordination of their care for our plan participants,” said Stephen Farrell, CEO, UnitedHealthcare of New England. “This ACO with ProHealth will help deliver better quality, improved outcomes and lower costs for our health plan customers in Connecticut.”
Care providers nationwide are showing strong interest in a shift to value-based care. UnitedHealthcare’s physician and hospital reimbursements that are tied to accountable care programs, centers of excellence and performance-based arrangements have nearly tripled in the last three years to $36 billion. The company projects this reimbursement will reach $65 billion by 2018. For more information about UnitedHealthcare’s accountable care organization initiatives, visit www.AccountableCareAnswers.com.
UnitedHealthcare serves nearly 500,000 people in Connecticut with a care provider network of 44 hospitals and more than 12,700 physicians statewide.
About ProHealth Physicians
ProHealth Physicians is Connecticut’s largest physician-owned healthcare delivery system, operating more than 95 practices throughout Connecticut, serving more than 380,000 active patients, and completing more than 850,000 patient encounters per year. ProHealth is based in Farmington, Conn. Formed in 1997, ProHealth has grown to include more than 350 primary care and specialty providers and offers select specialty and diagnostic/therapeutic services, such as ENT, pediatric and adult gastroenterology, plastic surgery, imaging, physical therapy, sleep medicine services, ADHD diagnosis and treatment, audiology, and regional Express Care walk-in centers to meet patients’ needs for access and convenience. For the past 15 years, ProHealth’s clinical performance program has enabled its providers to identify patients who are due for specific healthcare screenings and tests based on the clinical guidelines relevant to the individual patient’s condition. ProHealth has participated in the Medicare Shared Savings Program since 2013 and is contracted to care for an additional 100,000 patients through commercial shared savings agreements. ProHealth cares for more than 10 percent of Connecticut’s population and continues to expand throughout the state.
UnitedHealthcare is dedicated to helping people nationwide live healthier lives by simplifying the health care experience, meeting consumer health and wellness needs, and sustaining trusted relationships with care providers. The company offers the full spectrum of health benefit programs for individuals, employers, military service members, retirees and their families,and Medicare and Medicaid beneficiaries, and contracts directly with more than 800,000 physicians and care professionals, and 6,000 hospitals and other care facilities nationwide. Globally, UnitedHealthcare serves 45 million people in health benefits and is one of the businesses of UnitedHealth Group (NYSE: UNH), a diversified Fortune 50 health and well-being company. For more information, visit UnitedHealthcare at www.uhc.com or follow @myUHC on Twitter.