UnitedHealthcare Launches New Value-Based Care Payment to Help Improve Health Outcomes & Reduce Costs for Knee, Hip & Spine P...
December 01 2016 - 10:00AM
Business Wire
- Bundled payment program works in
connection with high-quality, efficient health care providers in 25
markets to help improve care for musculoskeletal
procedures
- Initial participating employers
report an average savings of $10,000 or more per operation, and
fewer patient complications and readmissions
- Large and mid-sized companies
nationwide can now participate in the program, with more than 2.2
million people eligible as of 2017
UnitedHealthcare has launched a new value-based care payment for
knee, hip and spine procedures that focuses on quality patient care
and better outcomes. The initiative – the Spine and Joint Solution
– is available to employers nationwide and works with health care
facilities that perform a higher number of these surgeries and have
demonstrated better outcomes and fewer complications.
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The Spine and Joint Solution from
UnitedHealthcare is a new care payment that helps improve outcomes
and reduces cost for knee, hip and spine procedures (Graphic:
UnitedHealthcare).
The Spine and Joint Solution gives UnitedHealthcare
employer-sponsored plan participants access to surgeons and
facilities that qualify as UnitedHealthcare Centers of Excellence
and accept bundled case rates for certain procedures, including
knee and hip replacement, spinal fusion and spinal disc repair. The
program currently includes more than 40 health care facilities in
25 markets across the country, with plans to expand to more than 40
markets during 2017.
The bundled payment method reimburses a care provider or
hospital 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 common 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 is currently available nationwide
to large and mid-sized companies with self-funded health plans,
helping expand access to high-quality, cost-effective care and
potentially saving employees out-of-pocket costs. Since the
program’s introduction as a pilot in 2015, participating employers
have recorded an average savings of $10,000 or more per operation
when compared with median costs in the same metropolitan area.
Through the initiative, eligible employees may save more than
$1,000 in out-of-pocket costs per procedure when accessing a
participating facility rather than another in-network medical
facility.
Musculoskeletal procedures are becoming increasingly common due
to an aging population and higher obesity rates. For instance, the
number of knee replacement surgeries performed nationally is
expected to increase by 500 percent by 2030, according to a recent
study from the Healthcare Cost and Utilization Project. Moreover,
these surgical procedures are expensive (knee/hip replacements
average $35,000 per operation), and costs vary widely among care
providers.
“Knee, hip and spine surgeries are among of the fastest
increasing categories of medical procedures, so this program
provides a new way to help improve the quality of care, produce
better outcomes for patients and better manage costs for
employers,” said Sam Ho, M.D., chief medical officer of
UnitedHealthcare. “Our partnership with participating health care
providers and facilities is an important step toward achieving
better health outcomes while reducing the overall cost of
care.”
UnitedHealthcare Value-Based Care Portfolio Continues to
GrowValue-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 nearly $50 billion annually, and
are expected to reach $65 billion by the end of 2018. To date, more
than 14 million people, or nearly one in every three people
enrolled in UnitedHealthcare benefit plans, currently access care
from providers in value-based care relationships.
The Spine and Joint Solution currently partners with health care
facilities that have been independently evaluated for providing
quality patient care and better outcomes. Participating facilities
are located in major markets nationwide, including Boston, Chicago,
Dallas and Los Angeles.
“Providing the best outcomes and an exceptional patient
experience in an affordable way are key to helping our patients
live healthier lives,” said Tim Cappel, executive director of
Population Health Management for Cincinnati’s The Christ Hospital,
one of first facilities to participate in the program. “Employers
seeking effective cost-containment strategies recognize the value
of fixed and competitive prices. Through these and other innovative
approaches, The Christ Hospital Health Network is transforming the
way our patients receive care.”
For more information about the Spine and Joint Solution and
Value-Based Care, visit www.uhc.com/valuebasedcare.
About
UnitedHealthcareUnitedHealthcare is dedicated to helping
people nationwide live healthier lives by simplifying the health
care experience, meeting consumer health and wellness needs, and
sustaining trusted relationships with care providers. The company
offers the full spectrum of health benefit programs for
individuals, employers, military service members, retirees and
their families, and Medicare and Medicaid beneficiaries, and
contracts directly with 1 million physicians and care
professionals, and 6,000 hospitals and other care facilities
nationwide. UnitedHealthcare is one of the businesses of
UnitedHealth Group (NYSE: UNH), a diversified Fortune 50 health and
well-being company. For more information, visit UnitedHealthcare at
www.uhc.com or follow @myUHC on Twitter.
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UnitedHealthcareWill Shanley,
714-204-8005will.shanley@uhc.com
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