Care Providers and Value-Based Care
Value-based care means care providers receive the support, resources and compensation necessary to care for the overall population they serve, while being rewarded for improving individual patients’ health.
With value-based care, technology tools, powerful information and actionable data support the success of care providers’ practices, while enhancing the patient experience.
What Value-Based Care Means for Care Providers
Better Efficiency & Care Coordination
Physicians have a complete view of a patient’s care across the entire health care system (PCP, specialists, hospital, pharmacy, etc.), with greater freedom in how they practice, thanks to compensation that rewards care coordination and outcomes.
Influencing Population Health
High-performing care providers grow the patient population they’re serving, giving them greater influence over the quality of care delivered and patient outcomes.
Data & Technology Support
Physicians receive data and analytics across the entire patient population they manage, as well as information comparing their outcomes to those of peers in their community.
Care providers are paid based on value – the right and most efficient care – refocusing health care on patient outcomes and quality, rather than volume.
UnitedHealthcare is Committed to Helping Providers Shift to Value-Based Care
UnitedHealthcare is helping physicians and hospitals across the country shift to a value-based health care system in which an increasing amount of their compensation is based on quality and improved patient health outcomes, rather than the number of procedures they perform.
We currently deliver $54 billion in care annually through value-based contracts, representing about one-third of our total payments to physicians and hospitals, and are on course to raise that to $65 billion by 2018.
Growth in Value-Based Programs
Total Value-Based Payments to Care Providers (in billions)
UnitedHealthcare Differs From its Competitors
There is tremendous breadth in how value-based care can be implemented with care providers. It’s not a one-size-fits-all approach.
UnitedHealthcare has more than 30 years’ experience building new payment models and integrating clinical support to place greater focus on quality and patients’ health outcomes.
We’re flexible and adaptable to care providers’ individual level of readiness to manage population health and potentially share the risks and rewards that come with basing a larger portion of their compensation on performance-based measures.
A Full Spectrum of Value-Based Programs
UnitedHealthcare offers a broad range of programs to help care providers transition to value-based care, based on their level of readiness to share greater financial accountability and manage overall population health.
Learn more about the payment models UnitedHealthcare offers to care providers.
Assisting Care Providers
Collaboration means supporting care providers in a number of ways:
- Technology and data support, including integrated health IT systems and sharing important patient information.
- Smarter compensation, including financial rewards for delivering best-practice care, improved access and excellent patient results at lower costs. This approach refocuses health care on patient outcomes.
- About one-third of our total payments to care providers participating in our networks is linked to value-based care. Those payments total $49 billion so far in 2016, and we expect this to grow to $65 billion by 2018.
- Performance-based contracts and value-based programs are available nationwide, across plans paid for by individuals, businesses, Medicare and Medicaid.
- Growing their patient populations by encouraging incentives for consumers who select high-performing care providers, such as those identified through our UnitedHealth Premium® Designation ProgramOpens a new window.
- On average, specialists who have achieved Premium Tier 1 status earn higher quality ratings and are 16 percent more cost-effective. Learn more about UnitedHealth PremiumOpens a new window.
- Meeting with care providers at certain milestones and checkpoints to track and monitor how well they are doing through the year.
Data and Technology Support
Value-based care is more than just changing how we pay for care.
With 30 years of experience, UnitedHealthcare has built technology that makes value-based care manageable for physicians and other care providers. We can provide data and analytics across the entire patient population a practice is managing, as well as compare that performance to peers in the community.
Our care management platform enables clinical teams in multiple organizations to connect and collaborate as a unified care team for a single patient. Known as CommunityCare™, our technology solution includes a suite of applications to:
- Enroll patients.
- Develop care teams.
- Receive alerts on admissions/discharges/transfers.
- Document and share care plans across the patient’s care team.
Additionally, clinicians using CommunityCare can securely message each other and share continuity of care documents from electronic medical records.