Published June 04, 2015
Advocate Health Care and UnitedHealthcare are expanding their accountable care relationship to help improve care coordination and enhance health services for more than 80,000 Illinois residents enrolled in UnitedHealthcare’s employer-sponsored health plans, beginning July 1, 2015.
Last year, Advocate Health Care and UnitedHealthcare launched their accountable care relationship for more than 5,500 Illinois residents enrolled in UnitedHealthcare’s Medicare Advantage plans. Under this newly expanded relationship, physicians and hospitals affiliated with Advocate Health Care will be rewarded for achieving certain evidence-based measures for care provided to people enrolled in UnitedHealthcare employer-sponsored health plans.
UnitedHealthcare will complement Advocate Health Care’s clinical care and data by giving the group’s 5,500 physicians support needed to manage overall population health, including technology and information that will help them take specific actions that improve quality and lower costs. Actionable data can include patient profiles, specific Healthcare Effectiveness Data and Information Set (HEDIS) gaps, and real-time information about emergency room and inpatient admissions. Patient navigators may also support community-based care coordination, such as helping with transition plans after an individual is discharged from the hospital, scheduling follow-up appointments and closing care gaps.
“We are working with UnitedHealthcare to apply our expertise in health care innovation and patient-centered programs to improve the health of UnitedHealthcare’s plan participants and the broader Illinois community,” said Mike Englehart, president of Advocate Physician Partners. “Together, we can achieve better health outcomes and improve patient satisfaction, while reducing the overall cost of care.”
The expanded accountable care relationship will also help transition Advocate Health Care away from a fee-for-service compensation model to a value-based approach in which physicians are eligible to receive payment incentives based on achieving higher patient satisfaction, certain evidence-based measures – such as hospital readmission rates, disease management and prevention, and patient safety – as well as total cost savings.
“Our collaboration with Advocate Health Care 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,” said Colleen Van Ham, president and CEO, UnitedHealthcare of Illinois.
UnitedHealthcare employer-sponsored plan participants who currently receive care from Advocate Health Care primary care physicians will not have to do anything differently to benefit from this new relationship.
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.
Advocate Health Care represents 14 acute-care hospitals, more than 6,300 affiliated physicians, home health services and a network of outpatient centers. Advocate Health Care is the largest integrated health care system in Illinois, with more than 250 sites of care. The accountable care relationship also includes Advocate Health Care’s clinical affiliate Silver Cross Hospital in New Lenox, Illinois, and its physician partners.
The relationship between Advocate Health Care and UnitedHealthcare is one of 250 new accountable care relationships UnitedHealthcare has committed to in 2015 as it engages in deeper, more collaborative relationships with physicians and hospitals across the United States. 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 nearly 1.4 million Illinois residents with a network of 233 hospitals and more than 36,000 physicians and other care providers statewide.
About Advocate Health Care
Advocate Health Care, named among the nation’s top five large health systems based on quality by Truven Analytics, is the largest health system in Illinois and one of the largest health care providers in the Midwest. Advocate operates more than 250 sites of care, including 12 hospitals that encompass 11 acute care hospitals, the state’s largest integrated children’s network, five Level I trauma centers (the state’s highest designation in trauma care), three Level II trauma centers, one of the area’s largest home health care companies and one of the region’s largest medical groups. Advocate Health Care trains more primary care physicians and residents at its four teaching hospitals than any other health system in the state. As a not-for-profit, mission-based health system affiliated with the Evangelical Lutheran Church in America and the United Church of Christ, Advocate contributed $661 million in charitable care and services to communities across Chicagoland and Central Illinois in 2013.
About Advocate Physician Partners
Advocate Physician Partners (APP) brings together more than 4,800 physicians who are committed to improving health care quality, safety and outcomes for patients across Chicagoland and Central Illinois. Formed as a care management collaboration with Advocate Health Care, APP is a leader in population health management and has garnered widespread national recognition for its innovative clinical integration program. Physicians and their patients benefit from a coordinated approach to addressing patient health needs across the continuum—ensuring care is delivered at the right place and at the right time. This results in more efficiency, improved health outcomes and significant cost savings for patients. With more than 600,000 patients in value-based agreements, APP was named the largest ACO in the U.S. by Modern Healthcare.
About UnitedHealthcare
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 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.