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Advancing ACO Collaboration - May Webinar Playback Now Available

June 6, 2017

The transition from volume-based care to value-based care helps promote better health, better care and lower costs through innovative partnerships with care providers and consumers.

Evolving our ACO Relationships
UnitedHealthcare’s Network Solutions and Accountable Care Organization (ACO) approach is centered on maximizing new market opportunities and optimizing health system performance. Our ACO collaboration revolves around embracing value-based care to help:

  • Drive incremental value by creating networks tailored to each market’s unique needs and competitive cost structure.
  • Align financial incentives; data sharing and clinical integration to push delivery system change – leading to stronger collaborative partnerships between UnitedHealthcare and care providers with a shared focus on the consumer.
  • Increase the emphasis and urgency on performance and incentive-based contracts – that reward for quality, outcomes, and lowering cost of care.

We have established a new level of collaboration to help ACOs be successful – through shared savings and shared risk arrangements, quality measures/incentives, population health risk assessments, new product designs, electronic gateways to reduce administrative costs, and local ACO team support.

Collaborating with ACO Physicians
UnitedHealthcare collaborates with ACO physicians to share data and insights to help support consistent, quality clinical outcomes. This is achieved by connecting our members with tools and information that helps them to find the right providers and care.

ACO Activation Teams
Our local ACO activation team coordinates and supports the success of each ACO relationship. The ACO support model includes a multidisciplinary team:

  • Clinical Transformation Consultant – provides day-to-day clinical contact with the ACO. In partnership with the ACO, prepares clinical action plans based on economic and clinical opportunities, and identification and implementation of process improvement activities.
  • Market Medical Director – is the primary clinical executive for collaboration with the ACO clinical leadership. Includes ongoing engagement with the Practice Chief Medical Officer (CMO) and Clinical Transformation Consultant.
  • Health Care Economics – supports contract negotiations, analytics and ongoing reporting. Each region will have a dedicated ACO health care economics staff member.
  • ACO Account Manager – coordinates our ACO relationship management and provides roster and member attribution management.

Alignment of ACO Activities and Optum Care Management Programs
Successful alignment of ACO activities with specific programs to fill gaps requires that we identify people, processes, and technology-based capabilities of the ACO to help perform the following:

  • Ability to identify and manage high-risk members and close gaps in care.
  • Adherence to evidence-based medicine, quality measurements and risk adjustment clinical support programs.
  • Care management pathways and protocols including in-home, high-risk patient assessment.
  • Disease management and wellness support for populations.

Assessments of all the areas above are captured within the Patient Profile to provide a transparent view of:

  1. Providers Seen and Why
  2. Inpatient Visits
  3. ER Visits
  4. Quality Gaps in Care

The Patient Profile enables all ACOs to see all Optum program enrollments – allowing ACOs to help manage a member’s care.

Innovative Solutions for Commercial ACO Results
With the use of UnitedHealthcare’s ACO Savings Planner app, ACOs are able to simulate ACO cost savings and potential future savings opportunities. ACOs have the ability to:

  • View utilization trends across five metrics,
  • Explore opportunities for improvements and savings,
  • Compare their actual performance against their peers, and
  • Review best practices to achieve success.

Furthermore, UnitedHealthcare’s Value-based Care programs help enable opportunities for improvements in care working with ACO providers and may lead to real benefits for employer and their employees. Take a look at these commercial ACO results:

*UnitedHealthcare Value-based Care Report, November 2016

Overall, UnitedHealthcare is leading the way in value-based care by reimagining how we collaborate with physicians, and by connecting consumers with tools to help find the right care.

For more information about value-based care, visit uhc.com.

To listen to testimonials from our value-based care partners about our ACO approach, visit uhc.com.

To learn more about UnitedHealthcare’s Network Solutions – ACO Collaboration, listen to the playback of our recent webinar.

Contact your UnitedHealthcare representative with questions.