UnitedHealth, Aledade partner on Medicare Advantage accountable care program

AUTHOR Les Masterson

PUBLISHeD June 19, 2017

Dive Brief:

• UnitedHealthcare and Aledade are collaborating on a new accountable care organization (ACO) program that seeks to improve healthcare in Arkansas through care coordination and a team approach to patient care. 
• The partnership is Aledade’s first ACO program for Medicare Advantage (MA) beneficiaries. More than 15,000 of UnitedHealth’s MA members are eligible for the program. 
• UnitedHealth is the largest provider of MA plans in the U.S. and makes up 24% of the market. The payer is a major player in the MA markets in 42 states and the District of Columbia. UnitedHealth has more than 330,000 Arkansas members, including 46,000 in Medicare plans.

Dive Insight:

UnitedHealth makes up one-quarter of the MA market, which means that competitors and the healthcare industry are watching closely.

The payer has shown interest in ACOs and value-based care. It has more than 15 million members that have access to an ACO. The company also said total payments to physicians and hospitals tied to value-based arrangements have tripled the past three years to more than $54 billion. UnitedHealth expects to increase that amount to $65 billion by the end of 2018.

ACOs are also getting a lot of interest in the industry — especially because CMS is viewing ACOs as a way to improve quality and reduce readmissions and costs.

The UnitedHealth-Aledade partnership will allow Aledade to provide patient care under the value-based model and use technologies to let providers share information and work collaboratively. UnitedHealth will share data to help providers connect the many steps in a patient’s healthcare treatment. 

Will value-based projects like ACOs work in the long run? James Landman, director of healthcare finance policy at the Healthcare Financial Management Association, recently told Healthcare Dive, 

“Organizations that have really focused on this have achieved demonstrable results both in improvement of the patients’ conditions and in reducing the costs of their care."

However, Landman said it takes time. Organizations with the most success spent years developing clinically integrated networks or working with physician practices and dealing with capitated global payment contracts.

“Those capabilities take a lot of time to develop,” he said. “When they do, you start seeing traction and improvements in both quality and efficiency of care.”

http://www.healthcaredive.com/news/unitedhealth-aledade-medicare-advantage/445326/