Details
The research, published in JAMA Network Open, compared Optum patients in fully accountable Medicare Advantage plans — where Optum care teams take full financial and clinical responsibility for patients — with a national random sample of administrative claims data for patients served by traditional Medicare fee-for-service.
In every metric examined, the health of patients who were in Optum’s fully accountable care model showed statistically significant improvements.
By the numbers
When compared to Medicare fee-for-service patients, those in fully accountable care plans had:
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18% lower chance of an inpatient admission
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11% lower chance of an emergency department (ED) visit
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44% lower probability of a hospital admission for COPD or asthma complications
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6% fewer instances of an inpatient acute admission from the ED
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6% lower rates of return to the ED within 30 days
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9% lower chance of 30-day hospital readmission
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14% lower probability of avoidable ED visits
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10% lower chance of admission for stroke or myocardial infarction
Patient service and beyond
This research demonstrates how Optum and UnitedHealthcare’s unique approach to value-based care better serves Medicare Advantage patients and helps to deliver better health outcomes. The study also contributes to the body of evidence showing how Medicare Advantage — with consumer-focused plans and additional benefits not available in FFS — helps people find the best path of care at the right place and time, while reducing costs through modernized and coordinated clinical programs that address their unique needs.
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