Report underscores value in value-based care programs
- A new UnitedHealthcare report supports claims that value-based care can improve healthcare while reducing overall costs of care.
- Accountable care organizations serving employer-sponsored plan beneficiaries outperformed non-ACOs on 87% of quality measures tracked in 2017, up from 83% the previous year, according to the second annual Value-Based Care Report.
- UnitedHealthcare also found a positive impact on hospital readmissions, with ACOs having 17% lower rates than non-ACOs.
The report looked at value-based programs comprising more than 110,000 doctors and 1,100 hospitals that treat patients participating in UnitedHealthcare employer-sponsored, individual, Medicare and Medicaid plans.
About 15 million UnitedHealthcare beneficiaries currently use providers in value-based payment models, and about $64 billion of the insurer’s annual payments to providers are tied to value-based care. The company expects that figure to reach $75 billion by the end of 2020.
“Value-based care is creating a platform for positive change throughout the health care system,” Sam Ho, chief medical officer of UnitedHealthcare, said in a statement. “Patients get more consistent, quality care that is better coordinated and easier to navigate; health plans and care providers are working together on behalf of patients in new ways; and physicians are being rewarded for placing value and quality over volume.”
Working together, UnitedHealthcare and providers in value-based arrangements have identified and closed 50 million gaps in care since 2013, the report notes.
Among improvements, ACOs bested non-ACOs on 67% of the top quality measures. The top ACOs also had lower rates of emergency department use (13%), fewer inpatient admissions (8%) and more members getting breast cancer and colorectal screenings (5%), according to the report. In addition, physicians reaped $90 million in bonuses for quality compliance and identifying gaps in senior care.
The report also found providers taking on more risk. For example, 20% of providers in Medicare ACOs working with UnitedHealthcare expanded the amount or type of value-based payment in 2017.
In one case, Arizona Care Network reduced healthcare spend by millions of dollars in the two years since launching an ACO with UnitedHealthcare, and cut hospital stays by 25%. The ACO also saw a 30% uptick in UnitedHealthcare patients due to enhanced care coordination, the report says.
The jury is still out on whether value-based care methods actually improve safety and health while reducing costs. A recent Healthcare Financial Management Association survey of senior financial executives found commercial payers have been slower than expected in launching value-based programs.
While health plans’ use of value-based methods doubled from 12% to 24% since 2015, that’s well below the expected 50% by 2018 projected at the time.
Still, nearly three-fourths of respondents cited financial gains from their value-based arrangements, including return on investment.