UnitedHealthcare's Value-Based Care Program for Knee, Hip & Spine Procedures Demonstrates Improved Health Outcomes & Reduced ...
May 09 2018 - 8:00AM
Business Wire
- Bundled payment program achieved a
22 percent reduction in hospital readmissions and 17 percent fewer
complications for people undergoing knee- and hip-replacement
surgeries
- Total savings for participating
employers of nearly $18 million, an average of $18,000 per
procedure, while individuals saved more than $3,000 per
procedure
- Program has added additional
financial incentives for employees and has been expanded to 46
participating health care facilities, each recognized for
high-quality care
UnitedHealthcare’s value-based care program for knee, hip and
spine procedures has demonstrated fewer hospital readmissions and
complications following surgery, while generating total savings of
nearly $18 million for participating employers.
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The Spine and Joint Solution is helping
improve health outcomes for knee, hip and spinal surgeries, while
reducing costs for employers and lowering out-of-pocket expenses
for employees. (Graphic: UnitedHealthcare)
The Spine and Joint Solution helped reduce hospital readmissions
by 22 percent and led to 17 percent fewer complications for joint
replacement surgeries, as compared to nonparticipating facilities.
For spine surgeries, hospital readmissions were reduced by 10
percent, and there were 3.4 percent fewer complications, as
compared to nonparticipating facilities.
Since the program’s introduction, participating employers have
realized an average savings of $18,000 per operation when compared
with median costs in the same metropolitan area. Eligible employees
saved more than $3,000 in out-of-pocket costs per procedure when
accessing a participating facility rather than another in-network
medical facility, with incentives such as cash, gift cards,
additional vacation days for recovery, and health savings account
(HSA) contributions.
The program’s bundled payment method reimburses health care
providers and facilities for a defined episode of care, such as
knee or hip replacement, under a single fee or payment. This is a
shift away from the traditional fee-for-service structure in which
a care provider is paid for each treatment, appointment or test,
generating multiple claims within a single, broader episode of
care.
The Spine and Joint Solution has expanded nationwide to 46
participating health care facilities, with more than 115 employers
enrolled and 3 million employees. The program, available to
companies of any size with self-funded health plans, provides
employees with access to surgeons and facilities that qualify as
UnitedHealthcare Centers of Excellence and accept bundled case
rates for knee and hip replacement, spinal fusion and spinal disc
repair. All participating health care facilities have been
independently evaluated for providing quality patient care and
better outcomes.
“This program is one example of the ways we are reshaping how
health care is delivered, helping enhance care coordination,
improve outcomes and deliver greater value,” said Sam Ho, M.D.,
chief medical officer of UnitedHealthcare. “The initial results and
nationwide expansion demonstrate the value of this program to
health care providers, employers and their employees, helping to
improve health outcomes and make care more affordable for more
people.”
Musculoskeletal procedures are becoming more common due to an
aging population and higher obesity rates. Moreover, these
procedures are expensive, and costs and outcomes vary widely among
care providers.
“Working with UnitedHealthcare on this program has furthered our
efforts to treat the whole person, providing patients with access
to comprehensive, coordinated care,” said Mark Carley, vice
president of managed care and payor relations, Centura Health,
which has participated in the Spine and Joint Solution since 2016.
“Employers are seeking new ways to enhance employee health and
reduce costs. By effectively coordinating patient care among the
primary care provider, the surgeon, hospital and health plan, we
can improve postoperative care, reduce readmissions, and enhance
outcomes and the patient experience, leading to healthier
communities.”
The Spine and Joint Solution was developed in collaboration with
Optum, a UnitedHealth Group (NYSE: UNH) company.
UnitedHealthcare Value-Based Care Portfolio Continues to
Grow
Value-based care models have made tremendous gains in adoption
across America’s health care system over the last few years.
UnitedHealthcare’s care provider reimbursements that are tied to a
variety of value-based care arrangements have nearly tripled in the
last three years to $64 billion annually, and are expected to reach
$75 billion by the end of 2020.
To date, more than 15 million people, or nearly one in every
three people enrolled in UnitedHealthcare benefit plans, currently
access care from providers in value-based care relationships.
UnitedHealth Group (NYSE: UNH) recently announced advancements
in the company’s collaboration with individual doctors, health
systems and governments as the use of bundled payment models
expands in traditional fee-for-service Medicare. UnitedHealth Group
aims to offer data and analytics, technology and care coordination
to support the bundled payment models of health care providers,
including those participating in the Centers for Medicare &
Medicaid Services (CMS) Bundled Payments for Care Improvement
Advanced (BPCI Advanced) program when BPCI Advanced launches later
this year.
For more information about Value-Based Care, visit
www.uhc.com/valuebasedcare.
About
UnitedHealthcareUnitedHealthcare 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 1.2 million
physicians and care professionals, and 6,500 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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version on businesswire.com: https://www.businesswire.com/news/home/20180509005151/en/
UnitedHealthcareWill Shanley,
714-204-8005will.shanley@uhc.com
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