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More than 12,300 UnitedHealthcare employer-sponsored health plan
participants in New Mexico have access to improved care coordination
and enhanced health services
Presbyterian Healthcare Services and UnitedHealthcare are launching an
accountable care organization (ACO) to improve care coordination and
enhance health services for more than 12,300 New Mexico residents
enrolled in UnitedHealthcare’s employer-sponsored health plans.
The partnership builds on efforts by both organizations to shift New
Mexico’s health care system to one that rewards quality and value
instead of the volume of procedures performed. Presbyterian Healthcare
Services, a not-for-profit integrated system with eight hospitals, more
than 100 clinics, and a medical group of more than 700 physicians, has
extensive experience in accountable care and improving the health of
individuals and populations.
Presbyterian is one of 250 accountable care programs UnitedHealthcare
has committed to in 2015 as it engages in deeper, more collaborative
relationships with physicians and hospitals across the United States.
UnitedHealthcare will complement Presbyterian’s own data by providing
additional support to manage overall population health, including
technology and information that will enable care providers to take
specific actions that improve quality and lower costs. This may include
data on patient profiles, specific quality gaps, and real-time Emergency
Department and inpatient admissions. Patient navigators may also be used
to support community-based care coordination, such as helping with
transition plans after a patient is discharged from the hospital.
“Presbyterian is focused on improving the health of the patients and
members we serve,” said Kathy Davis, RN, senior vice president and chief
nursing officer, Presbyterian Healthcare Services. “This partnership
aligns with our emphasis on improving the quality and coordination of
care. By focusing on several key quality measures, we hope to make a
significant impact on patient health.”
By participating in the ACO, Presbyterian care providers will be
eligible to receive payment incentives based on patient satisfaction,
achieving certain evidence-based measures – such as hospital readmission
rates, disease management and prevention, and patient safety – as well
as total cost savings. UnitedHealthcare employer-sponsored plan
participants who currently receive care from Presbyterian’s care
providers will not have to do anything differently to benefit from this
new relationship.
“Our ACO partnership with Presbyterian Healthcare Services enables us to
connect the people we serve to the right, most effective care, place a
greater focus on care quality, and compensate care providers for
improving patients’ health,” said Beth Soberg, president and CEO,
UnitedHealthcare in New Mexico.
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. Presbyterian
also has experience with value-based care, with almost two-thirds of
operating revenue tied to value-based arrangements.
UnitedHealthcare has more than 250 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 314,000 people in New Mexico with a
network of 38 hospitals and more than 5,700 physicians and other care
providers statewide.
About Presbyterian Healthcare Services
Presbyterian
Healthcare Services exists to improve the health of patients, members
and the communities we serve. Presbyterian was founded in New Mexico in
1908, and is the state’s only private, not-for-profit healthcare system.
The Presbyterian system includes eight hospitals, a statewide health
plan, and a growing multi-specialty medical group. Presbyterian is the
second largest private employer in New Mexico with more than 10,000
employees.
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 800,000 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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