More than 1,900 Care Providers Recognized with UnitedHealthcare PATH Excellence in Patient Service Award

Care providers address nearly 1.8 million care opportunities for Medicare Advantage members through participation in PATH program

UnitedHealthcare recently recognized more than 1,900 care providers with the 2015 UnitedHealthcare PATH Excellence in Patient Service Awards for their commitment to improving health outcomes for people enrolled in its Medicare Advantage plans.

These care providers achieved the UnitedHealthcare PATH Program’s performance metrics and successfully addressed care opportunities when treating UnitedHealthcare’s Medicare Advantage members. Nearly 1 million Medicare Advantage members are currently being treated by doctors who participate in the PATH program.

UnitedHealthcare created the PATH program to help people enrolled in its Medicare Advantage plans be as healthy as possible by encouraging greater use of preventive health care services and proactive monitoring of chronic conditions.

The program annually rewards physicians who meet certain performance-based criteria, including achieving or exceeding targets established by the Centers for Medicare & Medicaid Services (CMS) for specific Healthcare Effectiveness Data and Information Set (HEDIS) measures. Health plans and CMS use HEDIS as a tool to measure performance on important dimensions of health care and service.

Examples of the quality measures used to evaluate care providers’ performance in the 2015 PATH program include:

  • the percentages of eligible UnitedHealthcare Medicare Advantage members who received a breast cancer screening or colorectal cancer screening;
  • the percentage of members with diabetes who received an eye exam; and,
  • the percentage of members who received advice from their doctor to maintain or enhance their level of physical activity.

By achieving the PATH program’s performance metrics, care providers also proactively addressed care opportunities for UnitedHealthcare’s Medicare Advantage members. A care opportunity exists when an individual hasn’t received a health care service or medication recommended based on his or her age or health status. In 2015, care providers participating in the PATH program addressed nearly 1.8 million care opportunities for UnitedHealthcare’s Medicare Advantage members.

UnitedHealthcare representatives are meeting with care providers throughout the summer to present them with a PATH Excellence in Patient Service Award plaque and to personally thank them for their efforts to ensure the company’s Medicare Advantage members receive the preventive health care services that are so important to achieving optimal health.

“The care providers who earned a PATH Excellence in Patient Service Award deserve recognition for their commitment to improving our plan participants’ health and well-being,” said Efrem Castillo, M.D., chief medical officer of UnitedHealthcare Medicare & Retirement. “These awards are one of the ways we are supporting the transition to a value-based health care system that rewards physicians for the quality of care they deliver to the people we serve.”

The PATH program is part of UnitedHealthcare’s commitment to help shift the nation’s health care system to one that rewards quality and value instead of the volume of procedures performed. To facilitate this shift, the company offers a variety of value-based payment arrangements, including incentive programs like PATH, performance-based contracting, bundled payments and fully integrated accountable care organization (ACO) relationships.

Care providers nationwide are showing strong interest in a shift to value-based care. UnitedHealthcare’s total payments to physicians and hospitals that are tied to value-based arrangements have tripled in the last three years to $48 billion. By the end of 2018, UnitedHealthcare expects that figure to reach $65 billion.

Serving one in five Medicare beneficiaries, UnitedHealthcare is the largest business dedicated to the health and well-being needs of seniors and other Medicare beneficiaries. 

About the UnitedHealthcare PATH Program

The PATH program provides support and incentives for both care providers and UnitedHealthcare’s Medicare Advantage members to enhance their engagement in their health care and willingness to take action on their doctors’ treatment plan. The program has four components:

Patient Support and Communication: UnitedHealthcare supplements care providers’ patient engagement efforts through comprehensive communications to educate Medicare Advantage members about the importance of taking proactive steps to keep their health on track. Mailings, emails and phone calls to members emphasize the importance of working with their doctors to create a personalized preventive care plan as well as getting their annual care visit and any recommended tests and screenings. Reminders and financial incentives offer further encouragement to follow through on scheduling appointments and tests.

Actionable Patient Data and Reporting: UnitedHealthcare provides participating care providers with monthly Patient Care Opportunity Reports that include detailed patient-level and practice-level data in a format that is easy to use. The data facilitate the delivery of coordinated care by giving care providers a more complete picture of their patients’ health, including their hospitalizations, care they receive from other doctors and adherence to prescribed medications. On an ongoing basis, care providers can see at a glance the number of UnitedHealthcare Medicare Advantage patients who are overdue for an annual care visit or cancer screenings, for example, so they can take action to engage these patients and address their care opportunities.

Financial Compensation for Doctors: Because this type of patient engagement can require extra effort on the part of care providers, the PATH program offers financial compensation to care providers who exceed quality-based performance targets. Care providers who improve specific HEDIS measures for eligible UnitedHealthcare Medicare Advantage members can earn an annual bonus payment.

Support for Physician Practices to Enhance Care Coordination: UnitedHealthcare collaborates with care providers to provide additional tools, resources and support that can help facilitate care coordination and improve health outcomes. Given that every practice is different and has unique needs, UnitedHealthcare engages with practices in a variety of ways to offer customized support, such as joint communication efforts and on-site administrative and clinical resources.

All statistics throughout this article can be attributed to internal 2016 UnitedHealthcare data.

Plans are insured through UnitedHealthcare Insurance Company or one of its affiliated companies, a Medicare Advantage organization with a Medicare contract. Enrollment in the plan depends on the plan’s contract renewal with Medicare. This information is not a complete description of benefits. Contact the plan for more information. Limitations, co-payments, and restrictions may apply. Benefits, premium and/or co-payments/co-insurance may change on January 1 of each year.

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