Palo Alto Medical Foundation (PAMF) and UnitedHealthcare have launched an accountable care organization (ACO) to improve how patient care is coordinated and delivered for more than 63,000 Northern California residents enrolled in UnitedHealthcare’s employer-sponsored health plans.
The ACO will help shift California’s health care system to one that rewards quality and value instead of the volume of procedures performed. Specifically, the ACO will transition PAMF from a fee-for-service compensation model to a value-based approach in which the organization is rewarded for achieving certain evidence-based measures – such as hospital readmission rates, disease management and prevention, and patient safety — as well as total cost savings.
PAMF and UnitedHealthcare’s partnership is one of 250 new accountable care programs UnitedHealthcare has committed to in 2015 as it engages in deeper, more collaborative relationships with physicians and hospitals across the country.
PAMF is part of Sutter Health, a family of not-for-profit hospitals and physician organizations that share resources and expertise to advance health care quality throughout Northern California. PAMF has approximately 50 locations in Alameda, Contra Costa, San Mateo, Santa Clara and Santa Cruz counties.
“The Sutter Health network of care providers places a high value on coordinating care,” said Jeffrey Burnich, M.D., senior vice president of Medical and Market Networks at Sutter Health. “We’re excited about the potential for this new partnership to improve patient care.”
Through this collaboration, UnitedHealthcare will complement PAMF’s own data by providing additional support to manage overall population health, including technology and information that will help the group’s more than 500 primary care physicians take specific actions that improve quality and lower costs. Actionable data may include patient profiles, specific HEDIS performance measures on care and service, and real-time notification of ER and inpatient admissions. Patient navigators may also be used to support community-based care coordination, such as helping with transition plans after an individual is discharged from the hospital. This approach will enable physicians to identify best practices for overall patient wellness and disease management.
“We have long partnered with UnitedHealthcare to apply our expertise in health care innovation and care coordination to improve the health of our patients,” said PAMF CEO Richard Slavin, M.D. “Together, we can continue 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 PAMF-affiliated care providers will not have to do anything differently to benefit from this new relationship.
“UnitedHealthcare is building more collaborative relationships with the physicians caring for our plan participants so we can help enhance their health in meaningful ways,” said Brandon Cuevas, CEO, UnitedHealthcare of California. “Our collaboration with Palo Alto Medical Foundation is the latest in a series of value-based initiatives we’re launching in California that will help connect the people we collectively serve to the right, most effective care, place a greater focus on the quality of their care, and compensate care providers for improving patients’ health.”
Care providers nationwide are showing strong interest in a shift to value-based care. UnitedHealthcare’s total payments to physicians and hospitals that are tied to value-based arrangements have nearly tripled in the last three years to $38 billion. By the end of 2018, UnitedHealthcare expects that figure to reach $65 billion.
UnitedHealthcare has more than 520 active accountable care programs today. For more information about UnitedHealthcare’s full spectrum of value-based initiatives, visit www.AccountableCareAnswers.com.
UnitedHealthcare serves more than 3.2 million people in California with a care provider network of more than 320 hospitals and 60,000 physicians statewide.
About Palo Alto Medical Foundation
The Palo Alto Medical Foundation (PAMF) for Health Care, Research and Education, is part of the Sutter Health network of care. Founded in 1930, PAMF is a not-for-profit health care organization that is a pioneer in the multispecialty group practice of medicine, health innovation and patient-centered care. PAMF's more than 1,200 affiliated physicians and 5,400 employees serve nearly 850,000 patients at its medical centers and clinics in Alameda, Contra Costa, San Mateo, Santa Clara and Santa Cruz counties.
UnitedHealthcare is dedicated to helping people nationwide live healthier lives by simplifying the healthcare 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 850,000 physicians and care professionals, and 6,000 hospitals and other care facilities nationwide. UnitedHealthcare 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.