Employers and Value-Based Care

Imagine your health benefits being far more than a growing line item on your annual budget that you cannot seem to control. Imagine your health plan being a partner in the well-being of your workforce – providing the peace of mind and coordinated care that employees need to be their healthiest, most productive selves at work. That’s value-based care.

We believe value-based programs can transform how health care is paid for and delivered.

Employers will move away from a singular focus on network discounts negotiated by each health plan, and instead put more emphasis on the total cost of care for their employee population and the idea of paying for value, not volume.

UnitedHealthcare’s value-based programs offer improvements in care that lead to real benefits for employees and employers.

What Value-Based Care Means For Employers

 Healthier Workforce

Research has found that offering incentives to improve employee health leads to greater engagement, productivity and satisfaction, as well as improved health outcomes.

 Better Care For Employees

Employees receive the support they need to to lead healthy lifestyles and manage chronic conditions.

 Better Value

A focus on total cost of care – not just discounts from care providers – drives better care management, lowers overall costs and generates a greater return on investment from a company’s health care program.

 Cost Savings

Giving employees access to a network of high-performing care providers who are compensated based on quality and outcomes, and supporting them with high-touch care management programs, improves health and reduces costs.

Working With Physicians to Provide Better, More Cost-Effective Care

We are working with physicians and giving them the tools necessary to support their efforts to deliver better health, better care and lower costs.

Take the example of one of New York’s largest medical groups – WESTMED Medical Group. After its first year working as an accountable care organization with UnitedHealthcare, WESTMED improved on nine of 10 health quality metrics and reduced emergency department utilization by 8 percent. Read the full case studyOpens a new window.

UnitedHealth Premium Physicians

Over the past decade, we’ve built the industry’s largest and longest-running physician designation program. Our goal is to make it easy for UnitedHealthcare members to identify high-performing physicians and choose a care provider who has demonstrated that they provide high-quality care with excellent outcomes at lower costs.

Today, nearly 40 percent of our partnering physicians are designated as UnitedHealth Premium Tier 1 physicians. These physicians span 42 states and:

  • Comprise 40 percent of primary care physicians and 31 percent of specialists in our network.
  • Offer 27 specialties that influence 80 percent of costs.
  • Have lower rates of complications and lower rates of redo procedures.

Comparison of UnitedHealth Premium Tier 1 Physicians to Non-Tier 1 Physicians

18% lower costsMore Efficient Care and Better Quality
Between a Premium Tier 1 physician and a non-Tier 1 physician, 27 specialties evaluated.

23% lower costs
Implantable Cardiac Device
Premium Tier 1 specialists with cardiology procedure episodes had:

22% Lower average
complication rates
16% Fewer average
redo procedures

23% lower costs
Knee Replacement Surgeries
Premium Tier 1 specialists with orthopedic procedure episodes had:

19% Lower average
complication rates
20% Fewer average
redo procedures

A Continually Evolving Process

At UnitedHealthcare, we never stop working to develop innovative ways to strengthen the relationships between consumers and care providers.

We are building deeper, more trusting relationships with care providers and sharing accountability for enhancing the quality, accessibility and results of patient care.