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Although progress toward implementing value-based care has been slow, the healthcare industry remains on track and UnitedHealth Group is considering how best to accelerate that transformation. Masu.
In its latest “A Path Forward” report, UHG found that approximately 60% of United Healthcare members will receive physician services under a value-based arrangement in 2023, an increase from the previous year. The insurer said this reflects an effort to move away from value-based arrangements. Paid service model.
According to the report, value-based arrangements reduced healthcare costs for patients under these contracts by 12% and hospitalizations by 26%. Additionally, outcomes such as improved chronic disease management and improved preventive care were cited by UHG as evidence of the model’s success.
However, UHG said there are several key elements that are key to advancing and accelerating the transition to value-based care.
what is the impact
Sophisticated analytical tools are essential for identifying high-risk patients, managing chronic diseases, and giving healthcare providers access to actionable data in real-time, the report says.
It also emphasized the need for strong partnerships between payers and providers to create aligned incentives. UnitedHealth’s Optum division, which integrates healthcare services and technology, is playing a key role on this front by providing healthcare providers with the infrastructure they need to transition to a value-based model, according to UHG. That’s what it means.
One of the most important elements of UnitedHealth’s strategy has been a focus on addressing social determinants of health, including factors such as housing, nutrition and transportation. The authors argue that addressing these non-medical factors can have a significant impact on overall health status, especially in underserved populations.
Another key element of UnitedHealth’s strategy is promoting preventive care and the effective management of chronic diseases. The company said it is investing in programs that incentivize primary care visits and tests to help detect health problems early and manage chronic conditions before they become serious.
Nevertheless, challenges still exist. One major hurdle is that many providers are still stuck on a pay-as-you-go model, which can be difficult to break away from without sufficient financial incentives or support, the authors say. say: Smaller operations may also lack the technology infrastructure needed to succeed in a value-based environment.
In recent years, there has been movement at the policy level, with the Centers for Medicare and Medicaid Services promoting efforts to promote value-based arrangements. Programs such as the Medicare Shared Savings Program and various accountable care organization (ACO) models encourage health care providers to adopt value-based care frameworks.
However, the report emphasized the importance of continued innovation and collaboration across the health system to accelerate the adoption of value-based care. This includes working closely with policymakers to ensure that reimbursement structures are aligned with value-based care goals and that providers have access to the resources they need to make the transition. It will be.
bigger trends
According to the Medical Group Management Association’s 2022 report, value-based care still accounts for only a small portion of healthcare revenue in most specialties.
According to survey data, revenue from value-based contracts represents 6.74% of total medical revenue for primary care specialties, 5.54% for surgical specialties, and 14.74% for nonsurgical specialties.
Across all practices, the median revenue from value-based contracts was $30,922 per provider.
A JAMA Network study published this year found that value-based Medicare Advantage models improve patient outcomes and efficiency both generally and for specific metrics such as avoidable emergency department visits and hospital readmissions. I found out that
Jeff Lagasse is the editor of Healthcare Finance News.
Email: jlagasse@himss.org
Healthcare Finance News is a publication of HIMSS Media.
