Catalyst Health Network and UnitedHealthcare’s Accountable Care Relationship Improving Patient Care in North Texas
- Accountable care relationship significantly increased annual preventive screenings for cancer and diabetes while lowering health care costs.
PLANO, Texas – Catalyst Health Network (Catalyst) and UnitedHealthcare’s accountable care organization (ACO) has led to a significant increase in preventive screenings as well as a reduction in health care costs in North Texas since launching in 2015.
Cervical, breast and colorectal cancers rank among the top 10 leading causes of cancer deaths in the United States, but early detection greatly improves survival rates. Because of the enhanced collaboration between Catalyst and UnitedHealthcare, significantly more people in North Texas enrolled in UnitedHealthcare’s employer-sponsored plans received recommended preventive screenings:
- 5,300 members received breast cancer screenings, compared to 3,400 the previous year, an increase of nearly 56%
- 9,600 members received colorectal cancer screenings, compared to 6,300 the previous year, an increase of 52%
- 12,500 members received cervical cancer screenings, compared to 8,800 the previous year, an increase of 42%
Nearly 15 percent of the adult population in Texas has diabetes, costing an estimated $26 billion each year. Catalyst and UnitedHealthcare’s ACO has helped thousands of members achieve better control of their diabetes and reduce the risk of serious complications, such as heart disease, stroke, end-stage renal disease and blindness, through routine diabetes-related screenings:
- 2,000 members were screened for diabetic retinopathy (a condition that can cause blindness), compared to 1,300 the previous year, an increase of nearly 54%
- 4,300 members were screened for nephropathy (a serious kidney-related complication of diabetes), compared to 3,000 the previous year, an increase of 43%
- 1,500 members had an A1C level less than 8% (indicating well-controlled blood sugars), compared to 1,200 the previous year, an increase of 25%
“The relationship we have with UnitedHealthcare is making a positive impact on our community and the patients we serve,” said Christopher Crow, M.D., president of Catalyst Health Network. “We are proud of our results and are committed to achieving better patient outcomes through more efficient, collaborative and innovative care delivery.”
In the past three years, the accountable care relationship has lowered health care costs by more than $39.8 million1, including $10.8 million just this past year. These savings resulted from a number of factors, including improvements in the quality of care, a reduction in referrals to out-of-network providers and increased utilization of lower-cost care settings, all of which can result in lower out-of-pocket costs for members:
- 14% reduction in the use of out-of-network laboratory services.
- 13% reduction in the use of out-of-network specialists.
- 6% increase in utilization of lower-cost ambulatory surgical centers.
These improvements in health care quality and affordability resulted from collaboration between the two organizations. UnitedHealthcare provides an enhanced level of data and support to Catalyst to enable its providers to deliver more comprehensive care to their patients. For example, UnitedHealthcare shares data about members’ underlying medical conditions, past treatments, chronic conditions, gaps in care, medications and future care needs.
The data is actionable and specific to individual patients, empowering the Catalyst team of care coordinators, nurses, pharmacists, pharmacy techs and referral coordinators with a comprehensive picture of their patients’ health status and equipping them with valuable information that supports their efforts to provide quality care. Because of this collaboration, data and support, physicians can more easily identify patients who are at higher risk for an adverse health outcome such as an emergency room visit or readmission to the hospital, allowing them to intervene more quickly. They can also use the data to reduce duplicative tests and help patients manage their chronic conditions and take medications as prescribed.
“Our collaboration with Catalyst affirms that when everyone who touches a person’s health works together with a shared vision of a more coordinated care experience, the result is better-quality care at a lower cost,” said Scott Flannery, CEO of UnitedHealthcare of North Texas. “Accountable care relationships are one of the ways we can help transform our health care system. We look forward to continuing to work with Catalyst to drive further improvements in health outcomes and lower health care costs for the people of North Texas.”
Accountable care organizations are groups of health care providers who agree to work together to coordinate patient care and deliver the right care at the right time. ACOs help shift provider reimbursement to a value-based approach that rewards physicians based on their ability to deliver improved health outcomes and a better patient experience.
When ACOs are successful, they not only improve health outcomes but also lower health care costs. The savings generated by lowering the cost of care support care providers’ and health insurers’ efforts to improve the health care experience for their patients and members. For example, care providers can use the savings to invest more resources in enhancing the quality of care their physicians provide, while health insurers can lower out-of-pocket costs for members and strengthen the benefits available through their plans.
More than 17 million people enrolled in UnitedHealthcare plans have access to more than 1,200 accountable care programs nationwide.
About Catalyst Health Network
Catalyst Health Network is a URAC-accredited clinically integrated network of primary care physicians who have come together to provide high-quality care, helping communities thrive. With 790 primary care providers, 310 office locations, 1 million patients, and 100 care team members, Catalyst Health Network operates as a non-profit organization improving health, coordinating care, and lowering cost – creating sustainable and predictable value. The network is comprised solely of physician members and managed by StratiFi Health, a physician services and population health organization. For more information, visit www.catalysthealthnetwork.com
UnitedHealthcare is dedicated to helping people live healthier lives and making the health system work better for everyone by simplifying the health care experience, meeting consumer health and wellness needs, and sustaining trusted relationships with care providers. In the United States, UnitedHealthcare offers the full spectrum of health benefit programs for individuals, employers, and Medicare and Medicaid beneficiaries, and contracts directly with more than 1.5 million physicians and care professionals, and 7,000 hospitals and other care facilities nationwide. The company also provides health benefits and delivers care to people through owned and operated health care facilities in South America. UnitedHealthcare is one of the businesses of UnitedHealth Group (NYSE: UNH), a diversified health care company. For more information, visit UnitedHealthcare at www.uhc.com or follow @UHC on Twitter.
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