UnitedHealthcare has completed a successful enrollment season for its newest value-based plan design for January 2017, NexusACO™. Available nationally, NexusACO offers access to accountable care organization (ACO) providers with proven results for delivering quality and efficient care.
NexusACO enables self-funded employers to offer a national tiered benefit plan design that gives employers’ access to local ACOs in 15 major markets and to UnitedHealth Premium® designated physicians in other markets across the country. Additional ACOs will be added in 2018 and every six months thereafter. Employees have more control over their costs with the option to receive the highest value from their benefits by choosing these select “Tier 1” providers (a minimum 20 percent coinsurance benefit differential is required).
UnitedHealthcare’s goal with NexusACO is to:
Help improve the coordination of a patient’s care with the ACO’s unique care team structure;
Promote better health outcomes through the ACO’s commitment to population health; and
Deliver a better member care experience with the requirement that all members choose a primary care physician to help eliminate inefficiencies and unnecessary care.
The initial 15 NexusACO markets include:
Phoenix and Tucson, Ariz.
Los Angeles, Orange County and San Francisco Bay Area, Calif.
Northern New Jersey
Cleveland and Columbus, Ohio
Austin, Houston and San Antonio, Texas
Additional ACO markets will be added to the network in 2018.
UnitedHealthcare’s total payments to physicians and hospitals that are tied to value-based arrangements have more than tripled since 2011 to nearly $52 billion. By year-end 2018, UnitedHealthcare expects that figure to reach $65 billion. NexusACO will play an important role in that growth as our most recent value-based provider arrangement.1
More information about how UnitedHealthcare’s value-based programs are driving improvement in quality and people’s health is available in a November 2016 report: Value-Based Care Collaborative and Coordinated.
1 Savings estimates based on UnitedHealthcare's 2015 analysis in 164 markets. Figures are based on book-of-business results and represent the national average expected cost differential between Premium Care Physicians and non-Premium Care Physicians for entire episodes of care. Actual savings achieved will vary by customer depending on geographic availability and customer-specific service mix. All figures and estimated savings represent historical performance and are not a guarantee of future savings.