Wisconsin doctors earn $1.8 Million in bonus payments from UnitedHealthcare for improving health outcomes and closing gaps in care
Nearly 40 care providers in Wisconsin recognized with 2014 PATH Excellence in Patient Service Awards for hitting key quality measures in treatment of Medicare Advantage members
Program is helping encourage transition to value-based payments from fee-for-service approach
MILWAUKEE (July 27, 2015) – Approximately $1.8 million in bonus payments went from UnitedHealthcare to nearly 40 Wisconsin care providers named winners of the PATH Excellence in Patient Service Awards.*
The recipients achieved the highest adherence levels for key quality measures by successfully closing gaps in care when treating UnitedHealthcare Medicare Advantage members. They are among more than 4,000 care providers nationwide who received the award and earned more than $54 million in bonus payments.
The PATH program annually rewards physicians who meet certain performance-based criteria, including achieving or exceeding compliance targets for 17 specific Healthcare Effectiveness Data and Information Set (HEDIS) measures, including the percentages of eligible UnitedHealthcare Medicare Advantage members who received a breast cancer screening or colorectal cancer screening. Other measures evaluate the percentages of members who adhere to their medications to help manage their diabetes, high blood pressure or cholesterol.
Health plans and the Centers for Medicare & Medicaid Services use HEDIS as a tool to measure performance on important dimensions of health care and service.
“We are committed to recognizing and rewarding physicians in Wisconsin for consistently helping our plan participants live healthier lives,” said Sam Ho, M.D., chief medical officer of UnitedHealthcare. “As UnitedHealthcare continues building deeper, more collaborative relationships with care providers, the PATH Excellence in Patient Service Awards are just one step we are taking to support the transition to a value-based health care system in which payment is increasingly based on ensuring the people we serve receive the quality care they need.”
According to the Centers for Disease Control and Prevention, fewer than half of adults ages 65 and older were up to date with core preventive services, such as tests and screenings, despite getting regular check-ups from their doctors.** Because many chronic conditions are more common in older adults, preventive care becomes even more important with advancing age. Preventive care can identify health issues at an early stage, before they have an opportunity to intensify and lead to costly complications that can have a negative impact on people’s quality of life.
UnitedHealthcare created the PATH program to help its Medicare Advantage members be as healthy as possible by encouraging greater use of preventive health care services and proactive monitoring of chronic conditions. The program provides support and incentives for both care providers and Medicare Advantage members to enhance their engagement in their health care and willingness to take action on their doctors’ treatment plan, thereby closing gaps in care.
In 2015, nearly 1 million UnitedHealthcare Medicare Advantage members are being treated by doctors who participate in the PATH program.*
The PATH program is part of UnitedHealthcare’s commitment to help shift the nation’s health care system to one that rewards quality and value instead of the volume of procedures performed. To facilitate this shift, the company offers a variety of fee-for-value payment arrangements, including incentive programs like PATH, performance-based contracting, bundled payments and accountable care organization (ACO) relationships.
Care providers nationwide are showing strong interest in a shift to value-based care. UnitedHealthcare’s total payments to physicians and hospitals that are tied to value-based arrangements have nearly tripled in the last three years to $38 billion.* By the end of 2018, UnitedHealthcare expects that figure to reach $65 billion.*
Serving nearly one in five Medicare beneficiaries, UnitedHealthcare is the largest business dedicated to the health and well-being needs of seniors and other Medicare beneficiaries.*
For more information about UnitedHealthcare’s full spectrum of value-based initiatives, visitwww.AccountableCareAnswers.com.
About UnitedHealthcare
UnitedHealthcare 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 more than 850,000 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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*Internal UnitedHealthcare Data, 2015
**http://www.cdc.gov/aging/services/
Plans are insured through UnitedHealthcare Insurance Company or one of its affiliated
companies, a Medicare Advantage organization with a Medicare contract and a Medicare- approved Part D sponsor. Enrollment in the plan depends on the plan’s contract renewal with Medicare.
This information is not a complete description of benefits. Contact the plan for more information. Limitations, co-payments, and restrictions may apply. Benefits, premium and/or co–payments/co-insurance may change on January 1 of each year.
