Studies show UnitedHealthcare beats competition on total cost of care using best-practice methodologies

According to two new studies from third-party actuarial firms Santa Barbara Actuaries (SBA) and Wakely Consulting Group, UnitedHealthcare is reducing employers’ total cost of care better than the industry average, and its savings methodologies are consistent with industry best practices for key programs.

Employer costs are a combination of unit cost—typically measured through discounts—and utilization. Traditional consultant analyses capture discounts but do not capture utilization, including savings from factors such as site-of-care redirection and bed-day management, among others. Because discount tools typically don’t include these factors — and, therefore, don’t fully measure total cost of care — employers historically lack visibility into the potential for long-term savings.

About the studies

UnitedHealthcare engaged two actuarial firms to help consultants, brokers and employers understand that a total cost of care strategy must extend beyond traditional discount analyses. The studies’ results are designed to help ensure UnitedHealthcare is positioned accurately within requests for proposals and overall carrier evaluations.

  • SBA: In the first quarter 2022 study, SBA found that UnitedHealthcare’s evaluation methodologies are consistent with industry best practices across medical management1, advocacy, payment integrity and out-of-network management through Naviguard.
  • Wakely Consulting Group: By looking at risk-adjusted allowed claims per member per month (PMPM) in this first quarter 2022 study, Wakely was able to perform a holistic comparison of UnitedHealthcare’s ability to drive cost savings for members and determined it outperformed the market by ~10% — even though UnitedHealthcare is not the leader in discounts in many of these markets. Site of care redirection, inpatient management and preventive care utilization are key savings drivers.

What does this mean for employers?

Without considering the total cost of care savings a carrier can provide, an employer may not have the full financial picture in selecting a health insurance carrier. Employers looking to optimize their total cost of care strategy can:

  • Talk to their UnitedHealthcare account representative to understand the potential savings delivered through UnitedHealthcare’s broader total cost of care strategy
  • Talk to their broker or consultant about how their business is considering UnitedHealthcare’s ability to drive total cost of care

For more information on the results from these studies, please contact your broker or UnitedHealthcare representative. Download the full SBA study results. Download the full Wakely study results.

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