As the healthcare field takes a more value-based care approach, UnitedHealthcare is seeing positive results from its reimbursement model.
Here's what you should know.
1. The Centers for Medicare and Medicaid Services have set a goal of having half of all Medicare payments based on an alternative payment model by the end of 2018. That decision has spurred the industry towards adopting a value-based care reimbursement model.
One-third of all Medicare payments are value-based.
2. UnitedHealthcare created a value-based program in response to CMS' goal, which would reward physician groups for improved patient outcomes for patients enrolled in Medicare Advantage plans.
3. Recently, the insurer paid 1,900 providers with PATH Excellence in Patient Service Awards because they improved their patient outcomes.
4. A total of $148 million was distributed among the providers for meeting the performance metrics required in the PATH program.
5. Some of the things UnitedHealthcare measured included increased screening for breast and colorectal cancer, and giving diabetes patients eye exams. Additionally, the physicians provided patients with information on how to improve their level of physical fitness. The providers were also responsible for ensuring the patients received all the services and medications recommend for their age group.
6. UnitedHealthcare began their program in 2013, and have expanded it to almost 1 million Medicare Advantage members.
More coding, billing and cost news:
Latest payer ACA departures further limit consumers' options — 5 takeaways
Medicaid reimbursed 6 Texas institutions an extra $57.8M due to erroneous calculations — 6 things to know
AHIP proposes changes to ACA to help payers reap profits: 4 takeaways