Presbyterian Healthcare Services and UnitedHealthcare are launching an accountable care organization (ACO) to improve care coordination and enhance health services for more than 12,300 New Mexico residents enrolled in UnitedHealthcare’s employer-sponsored health plans.
The partnership builds on efforts by both organizations to shift New Mexico’s health care system to one that rewards quality and value instead of the volume of procedures performed. Presbyterian Healthcare Services, a not-for-profit integrated system with eight hospitals, more than 100 clinics, and a medical group of more than 700 physicians, has extensive experience in accountable care and improving the health of individuals and populations.
Presbyterian is one of 250 accountable care programs UnitedHealthcare has committed to in 2015 as it engages in deeper, more collaborative relationships with physicians and hospitals across the United States.
UnitedHealthcare will complement Presbyterian’s own data by providing additional support to manage overall population health, including technology and information that will enable care providers to take specific actions that improve quality and lower costs. This may include data on patient profiles, specific quality gaps, and real-time Emergency Department and inpatient admissions. Patient navigators may also be used to support community-based care coordination, such as helping with transition plans after a patient is discharged from the hospital.
“Presbyterian is focused on improving the health of the patients and members we serve,” said Kathy Davis, RN, senior vice president and chief nursing officer, Presbyterian Healthcare Services. “This partnership aligns with our emphasis on improving the quality and coordination of care. By focusing on several key quality measures, we hope to make a significant impact on patient health.”
By participating in the ACO, Presbyterian care providers will be eligible to receive payment incentives based on patient satisfaction, achieving certain evidence-based measures – such as hospital readmission rates, disease management and prevention, and patient safety – as well as total cost savings. UnitedHealthcare employer-sponsored plan participants who currently receive care from Presbyterian’s care providers will not have to do anything differently to benefit from this new relationship.
“Our ACO partnership with Presbyterian Healthcare Services enables us to connect the people we serve to the right, most effective care, place a greater focus on care quality, and compensate care providers for improving patients’ health,” said Beth Soberg, president and CEO, UnitedHealthcare in New Mexico.
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. Presbyterian also has experience with value-based care, with almost two-thirds of operating revenue tied to value-based arrangements.
UnitedHealthcare has more than 250 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 314,000 people in New Mexico with a network of 38 hospitals and more than 5,700 physicians and other care providers statewide.
About Presbyterian Healthcare Services
Presbyterian Healthcare Services exists to improve the health of patients, members and the communities we serve. Presbyterian was founded in New Mexico in 1908, and is the state’s only private, not-for-profit healthcare system. The Presbyterian system includes eight hospitals, a statewide health plan, and a growing multi-specialty medical group. Presbyterian is the second largest private employer in New Mexico with more than 10,000 employees.
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. 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.