UnitedHealthcare Pioneers National ACO Product; NexusACO Expands Access to Quality Care and Lowers Costs

December 07, 2016
  • New plan design is built around UnitedHealthcare's relationships with accountable care organizations (ACOs) and Tier 1 physicians

UnitedHealthcare has introduced NexusACO™, a new health benefits option for 2017 that offers access to highly accomplished care providers who have proven results for delivering quality and efficient care, resulting in better health outcomes and lower costs.

NexusACO will be available in 15 markets across the country to self-funded employers with 100 or more employees during this fall's open enrollment period, with coverage beginning Jan. 1, 2017.

"People enrolled in UnitedHealthcare's NexusACO plan will be able to choose a local primary care physician who will serve as a trusted expert who knows them, understands their needs and keeps them healthy while coordinating with other care providers supporting their care," said Jeff Alter, CEO of UnitedHealthcare Employer & Individual. "We believe people enrolled in the NexusACO plan will have a more satisfying experience, and will find it easier to navigate their health care options."

NexusACO's Tier 1 includes physicians associated with local accountable care organizations (ACOs) – organized groups of physicians, hospitals and other care providers working together to coordinate care for a designated patient population. ACOs participate in incentive programs designed to improve quality standards while providing more efficient care.

Through the NexusACO plan, UnitedHealthcare will collaborate with participating care providers to improve the coordination of a patient's care, including sharing timely data and information about emergency room visits, hospital admissions and other care received outside the doctor's office.

NexusACO enables national employers to offer a single plan design nationwide, giving employees access to in-network Tier 1 care providers.

NexusACO delivers value to consumers and employers through three key features:

  • Better care coordination. NexusACO plan participants will partner with a primary care physician (PCP), a trusted medical resource who helps to navigate the health care system, including specialists, hospitals and other care providers.
  • Promotes better health outcomes. NexusACO provides access to care providers who proactively engage their patients more frequently, ensuring at-risk patients receive timely, appropriate health screenings, and helping people manage chronic diseases like diabetes, heart disease and arthritis.
  • Lower costs for high-quality health care. Employers who choose NexusACO may achieve savings on overall health care costs. These savings come from the plan's emphasis on encouraging employees to use in-network Tier 1 care providers to coordinate their care.

The 15 markets with ACOs participating in NexusACO include: Phoenix and Tucson, Ariz.; Los Angeles, Orange County and San Francisco Bay Area, Calif.; Denver; Chicago; Northern New Jersey; Cleveland and Columbus, Ohio; Rhode Island (statewide); Austin, Houston and San Antonio, Texas; and Richmond, Va. Additional ACO markets will be added to the network in 2017.

Continued Growth of Value-Based Care

More than 14 million people enrolled in UnitedHealthcare plans across the country – nearly one in every three plan participants – are accessing care from care providers participating in value-based arrangements. UnitedHealthcare's total payments to physicians and hospitals that are tied to value-based arrangements have more than tripled since 2011 to nearly $52 billion. By the end of 2018, UnitedHealthcare expects that figure to reach $65 billion.

For more information about UnitedHealthcare's full spectrum of value-based initiatives, visit

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 1 million 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 or follow @myUHC on Twitter.