Study: Continued Advances Seen in Health Behaviors and Coordination of People’s Care from Value-based Care Arrangements


Published March 05, 2018

  • Closed 50 million gaps in care from 2013 through 2017
  • Nearly one in three UnitedHealthcare plan participants now receive care from care providers in value-based arrangements
  • Value-based care is lowering costs – nearly 20 percent fewer commercial plan participants require hospital admissions when receiving care in an Accountable Care Organization

UnitedHealthcare has released its second annual report detailing how the continued shift to a value-based health care system is encouraging better health and better care, and putting greater focus on the total cost of care. According to the study, UnitedHealthcare is seeing significant advances in people’s health behaviors, better coordination of care among physicians and facilities, and cost savings with care providers who have implemented value-based arrangements.

These arrangements focus on quality and using incentives to reward better health and lower costs, rather than reimbursing care providers based solely on the volume of services delivered. Among the report’s key findings:

  • Better Health: Accountable Care Organizations (ACOs) serving employer-sponsored plan participants perform better than non-ACOs on 87 percent of the quality metrics tracked.
  • Better Care: UnitedHealthcare and care providers in value-based relationships worked together to identify and close 50 million gaps in care from 2013 through 2017.
  • Lower Costs: Hospital admission rates are 17 percent lower for ACOs serving employer-sponsored and individual plan participants compared to non-ACOs.   

“Value-based care is creating a platform for positive change throughout the health care system,” said Dr. Sam Ho, chief medical officer of UnitedHealthcare. “Patients get more consistent, quality care that is better coordinated and easier to navigate; health plans and care providers are working together on behalf of patients in new ways; and physicians are being rewarded for placing value and quality over volume.”

Approximately 15 million people enrolled in UnitedHealthcare plans currently seek care from care providers in value-based arrangements. By comparing this sizable population to patients who seek care from care providers not participating in any form of value-based reimbursement, clear patterns have begun to emerge illustrating the benefit of enhanced care coordination, placing greater emphasis on keeping people healthy and rewarding care providers for lowering the total cost of care.

The analysis also found that care providers are expanding the amount and type of compensation that is tied to value-based measures. Among Medicare ACOs working with UnitedHealthcare, over the last year 20 percent have moved further along the risk continuum, which means they are sharing a greater portion of the responsibility for patients’ total care, including quality and health care costs.

The report examines a broad portfolio of value-based programs with more than 110,000 physicians and 1,100 hospitals that treat people enrolled in UnitedHealthcare employer-sponsored, individual, Medicare and Medicaid products.  

To support care providers, UnitedHealthcare shares clear, actionable data and analytics to improve the coordination of a patient’s care and take the burden off patients to connect and aggregate information from their various doctor visits and tests. This helps reduce duplicative tests and costs, alerts physicians to specific health events and changes in a patient’s treatment, and promotes a team-based approach to patient care.

“When an organization like UnitedHealthcare shares these kinds of unique insights with a trusted collaborator like Arizona Care Network, you get rapid results,” said David Hanekom, CEO, Arizona Care Network. “This is the kind of relationship that helps transform our health care system.”

Arizona Care Network, which serves patients in Maricopa and Pinal counties, was able to reduce its health care costs by millions of dollars within the first two years of its ACO with UnitedHealthcare, and patients requiring a hospital admission spent 25 percent less time in the hospital. Arizona Care Network also saw a 30 percent increase in the number of UnitedHealthcare patients it serves, thanks in part to the enhanced health care experience and care coordination from the ACO.

Today, approximately $64 billion of the total annual payments UnitedHealthcare makes to care providers is tied to value-based arrangements, and the company continues to expect that to rise to $75 billion by the end of 2020.

To download the full report, as well as infographics and commentary from UnitedHealthcare leaders, visit https://www.uhc.com/valuebasedcare.

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 www.uhc.com or follow @UHC on Twitter.