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UnitedHealthcare to Double ACO Contracts to $50 Billion by 2017

July 11, 2013
by Rajiv Leventhal
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UnitedHealthcare, the Minnetonka, Minn.-based health insurer, has announced that it expects to more than double its number of accountable care health plan contracts in the next five years.

Already more than $20 billion of UnitedHealthcare's reimbursements to hospitals, physicians and ancillary care providers are paid through contracts that link a portion of the reimbursement to quality and cost-efficiency measures. UnitedHealthcare expects that number to increase to $50 billion by 2017 as more care providers join the transition to accountable care contracts that reward quality and value-based health care.

UnitedHealthcare currently has accountable care relationships with more than 575 hospitals, 1,100 medical groups, and 75,000 physicians across the country.

"We are improving health outcomes for patients at lower costs by moving even more broadly to value-based payment models and integrating those with our care provider network, product and clinical strategies," Austin Pittman, president, UnitedHealthcare Networks, said in a statement.

UnitedHealthcare's ACO strategy includes three categories of programs that offer varying levels of integration with care providers depending on their ability to assume financial risk and affect health outcomes. The level of shared accountability and financial risk between UnitedHealthcare and care providers increases with each of the three programs:

  • Performance-based programs—may include bonus-based incentives for primary care practices, or performance-based contracts with hospitals, physicians and ancillary care providers that reward them for successfully improving patient health outcomes and lowering costs.
  • Centers of Excellence programs—reimbursements are bundled for specific treatments and/or procedures (e.g., organ transplants) rather than charging for each visit or drug administered.
  • Accountable care programs—ACOs and patient-centered medical homes (PCMH) are among the most common. In these programs, both the health plan and care provider share in the risk and savings associated with managing patients' health.
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