High-value physicians could save Medicare $287B, UnitedHealth says

Morgan Haefner – September 25, 2019

If all physicians caring for Medicare fee-for-service patients meet certain national cost and quality benchmarks, Medicare would save about $287 billion across the next decade, according to a brief published by UnitedHealth Group. 

UnitedHealth defined "high-value physicians" as those who meet quality and cost criteria under its UnitedHealth Premium Program. The program uses quality metrics from the National Quality Forum, the National Committee for Quality Assurance and other quality organizations, while cost metrics are based on market benchmarks.

Each year, UnitedHealth evaluates physicians against these benchmarks, and designates those who perform well as Premium Care physicians. Patients over age 65 who saw Premium Care physicians in 2018 saw 64 percent fewer inpatient hospital days, 35 percent fewer emergency department visits and 21 percent lower risk-adjusted spending, UnitedHealth said.

If all physicians performed like Premium Care physicians, costs would drop dramatically, according to UnitedHealth. The Medicare program would save $20.5 billion in 2020 alone, the insurer said. Savings would reflect 4 percent in annual Medicare fee-for-service spending.

Read the full brief here. 

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