DENVER (Jan. 2, 2014) People enrolled in UnitedHealthcare's employer-sponsored health benefit plans now have access to a new accountable care organization through Primary Physician Partners (PPP) and South Metro Primary Care (SMPC) that provides patients with quality, coordinated care while reducing costs.
More than 300 primary care providers with Primary Physician Partners and South Metro Primary Care, which are managed by Physician Health Partners, use innovative tools and programs to improve overall health care quality and reduce costs. More than 20,000 Denver-area residents who are UnitedHealthcare plan participants now have access to this distinctive care model.
Physician Health Partners will help Primary Physician Partners and South Metro Primary Care with care coordination and the provision of evidence-based care, ensuring that the primary care physicians, specialists and facilities are aligned with the Institute for Healthcare Improvement's (IHI's) "Triple Aim" objective: increase patient satisfaction, improve the health of the population and reduce the cost of health care.
Under the initiative, care providers will be rewarded for effectively managing all aspects of patients' treatment. Care Providers will be eligible for payment incentives based on meaningful improvements in measures such as hospital readmission rates, disease management and prevention, patient safety and care delivery, as well as total cost savings and patient satisfaction.
"The traditional health care model rewards volume-based medicine rather than emphasizing quality," said Ken Nielsen, president and CEO, Physician Health Partners. "We are excited to start the journey with UnitedHealthcare toward incentives for quality-based care, with the primary care provider at the center of patient-oriented health care."
"We look forward to working with these exceptional primary care physician groups to improve care and deliver greater value for employers," said Beth Soberg, president and CEO, UnitedHealthcare of Colorado. "Denver has proved to be ahead of the curve when it comes to increasing the quality of care for patients and reducing costs. This new initiative will bring that innovative and progressive approach to thousands' more Coloradoans."
UnitedHealthcare employer-sponsored plan participants who currently receive care from participating care providers will not have to do anything differently to receive the benefits of these agreements, which include enhanced care coordination and follow-up.
The latest ACO announcement is an example of UnitedHealthcare's commitment to providing increased quality and coordinated care in Colorado and across the nation. Earlier this year, UnitedHealthcare launched an ACO with New West Physicians in Denver, providing this innovative model to more than 14,000 Denver residents enrolled in UnitedHealthcare's employer-sponsored health plans.
"Based on results we have seen in other markets, it is clear we can achieve positive outcomes when medical professionals and insurers come together for a common goal getting patients to the right care at the right time in the right setting," said Sam Ho, M.D., chief medical officer of UnitedHealthcare. "Physician Health Partners has been a longstanding partner with a focus on value-based performance, and we look forward to furthering our relationship to increase the value of care and lower costs for more people in Denver."
Today, more than $27 billion of UnitedHealthcare's annual physician and hospital reimbursements are tied to accountable care programs, centers of excellence and performance-based programs. The company projects this will reach $65 billion by 2018.
About Physician Health Partners (PHP)
PHP is owned and operated by primary care physicians, including physicians in Primary Physician Partners (PPP) and South Metro Primary Care (SMPC), and was founded in 1996 as a management services organization. PHP collaborates with more than 300 primary care providers in the Denver metro area who share a goal of providing the right care, at the right time, and in the right setting to improve the quality of care and lower the costs associated. PHP manages two adult and one pediatric independent practice associations that are involved in several ACO initiatives. Additionally, PHP manages Colorado Community Health Alliance, the regional care collaborative organization for Colorado Medicaid region 6.
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 and Medicare and Medicaid beneficiaries, and contracts directly with 780,000 physicians and other health care professionals and 5,900 hospitals and other care facilities nationwide. UnitedHealthcare serves more than 40 million people in health benefits and is one of the businesses of UnitedHealth Group (NYSE: UNH), a diversified Fortune 50 health and well-being company.