The Pulse from UnitedHealthcare: Health Plan CEO discusses the future of value-based care

Value-based care has the power to deliver better health outcomes and experiences, along with reduced costs.

By Scott Flannery, Health Plan CEO of Texas and Oklahoma for UnitedHealthcare Employer & Individual

As the Health Plan CEO of Texas and Oklahoma for UnitedHealthcare Employer & Individual, I come to work each day thinking about the quadruple aim: simplifying the member experience, improving the provider experience, driving better health outcomes and reducing overall costs for employees and employers.

Value-based care, an arrangement which pays providers based on the quality and affordability they deliver to their patients, has the power to deliver on each of these goals. Frankly, I see it as the only way forward given the current cost trends we’re seeing in health care — but there’s a ways to go before we see widespread adoption.

It’s understandable: You can’t do things one way for decades and then flip a switch. I think our job is to help accelerate adoption along that continuum. Over time, we need to change the way providers, employees, employers and insurers think about care, and that’s a tall order. How do we get them from the former fee-for-service model to the pay-for-value model — and maybe even a risk model down the road? It’s going to come with patience and time.

At UnitedHealthcare, we believe in the value-based care model, which is why we’re working to accelerate its adoption by entering into value-based contracts with providers while also ensuring those providers are accountable for providing quality care.

One health plan that is gaining traction in Texas and Oklahoma is SurestTM, which helps provide members with clear, upfront health care cost and coverage information before making an appointment. If you need an MRI, for instance, and one facility will charge a $400 copay while another will charge a $700 copay, you have a choice — based on your budget, etc. — about where you’ll get that MRI. That gives you power over your health care and makes the experience more like what we’ve all come to expect of retail.

But we also have to replicate that experience for members who may not be comfortable with a digital shopping experience. That’s why we also offer support over the phone, where members can call and ask questions and be walked through their options.

Ultimately, to see the kind of quality care — which may yield better health outcomes, improved experiences and lower costs — requires a concerted effort on the part of insurers, but also of employers and employees.

More than two-thirds of our business is self-funded employers, and these have been some of our earliest adopters of value-based care — though our fully insured business is starting to catch up. Showing employers that value-based care may really move the needle on health outcomes and costs has been integral to getting them on board with what may initially feel like a narrow network.

Having the ability to show that value-based care models may yield lower costs may also help drive a better experience for members, because it aims to motivate those employees to think differently about how they’re using the health care system to encourage them to take a more active role and make more informed and cost-effective choices.

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