Palo Alto Medical Foundation (PAMF) and UnitedHealthcare have launched
an accountable care organization (ACO) to improve how patient care is
coordinated and delivered for more than 63,000 Northern California
residents enrolled in UnitedHealthcare’s employer-sponsored health plans.
The ACO will help shift California’s health care system to one that
rewards quality and value instead of the volume of procedures performed.
Specifically, the ACO will transition PAMF from a fee-for-service
compensation model to a value-based approach in which the organization
is rewarded for achieving certain evidence-based measures – such as
hospital readmission rates, disease management and prevention, and
patient safety – as well as total cost savings.
PAMF and UnitedHealthcare’s partnership is one of 250 new accountable
care programs UnitedHealthcare has committed to in 2015 as it engages in
deeper, more collaborative relationships with physicians and hospitals
across the country.
PAMF is part of Sutter Health, a family of not-for-profit hospitals and
physician organizations that share resources and expertise to advance
health care quality throughout Northern California. PAMF has
approximately 50 locations in Alameda, Contra Costa, San Mateo, Santa
Clara and Santa Cruz counties.
“The Sutter Health network of care providers places a high value on
coordinating care,” said Jeffrey Burnich, M.D., senior vice president of
Medical and Market Networks at Sutter Health. “We’re excited about the
potential for this new partnership to improve patient care.”
Through this collaboration, UnitedHealthcare will complement PAMF’s own
data by providing additional support to manage overall population
health, including technology and information that will help the group’s
more than 500 primary care physicians take specific actions that improve
quality and lower costs. Actionable data may include patient profiles,
specific HEDIS performance measures on care and service, and real-time
notification of ER and inpatient admissions. Patient navigators may also
be used to support community-based care coordination, such as helping
with transition plans after an individual is discharged from the
hospital. This approach will enable physicians to identify best
practices for overall patient wellness and disease management.
“We have long partnered with UnitedHealthcare to apply our expertise in
health care innovation and care coordination to improve the health of
our patients,” said PAMF CEO Richard Slavin, M.D. “Together, we can
continue to achieve better health outcomes and improve patient
satisfaction, while reducing the overall cost of care.”
UnitedHealthcare employer-sponsored plan participants who currently
receive care from PAMF-affiliated care providers will not have to do
anything differently to benefit from this new relationship.
“UnitedHealthcare is building more collaborative relationships with the
physicians caring for our plan participants so we can help enhance their
health in meaningful ways,” said Brandon Cuevas, CEO, UnitedHealthcare
of California. “Our collaboration with Palo Alto Medical Foundation is
the latest in a series of value-based initiatives we’re launching in
California that will help connect the people we collectively serve to
the right, most effective care, place a greater focus on the quality of
their care, and compensate care providers for improving patients’
health.”
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.
UnitedHealthcare has more than 520 active accountable care programs
today. For more information about UnitedHealthcare’s full spectrum of
value-based initiatives, visit www.AccountableCareAnswers.com.
UnitedHealthcare serves more than 3.2 million people in California with
a care provider network of more than 320 hospitals and 60,000 physicians
statewide.
About Palo Alto Medical Foundation
The
Palo
Alto Medical Foundation (PAMF) for Health Care, Research
and Education,
is part of the Sutter
Health network of care. Founded in 1930, PAMF is a
not-for-profit health care organization that is a pioneer in the
multispecialty group practice of medicine, health innovation and
patient-centered care. PAMF's more than 1,200 affiliated physicians and
5,400 employees serve nearly 850,000 patients at its medical centers and
clinics in Alameda, Contra Costa, San Mateo, Santa Clara and Santa Cruz
counties.
About UnitedHealthcare
UnitedHealthcare
is dedicated to helping people nationwide live healthier lives by
simplifying the healthcare 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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