Physicians Provide Higher Quality Care Under Set Monthly Payments Instead of Being Paid Per Service, UnitedHealth Group Study...
11 Agosto 2020 - 8:00AM
Business Wire
Global capitation payments provide strong
incentives for physicians to prioritize prevention, avoid
unnecessary interventions, and increase overall wellness
Primary care physicians paid under global capitation, which pays
a set amount per month per patient, achieve key quality metrics at
higher rates than those paid under fee-for-service (FFS), according
to new research by UnitedHealth Group (NYSE: UNH). The findings
indicate that capitation provides the right incentives for
value-based care, including delivery of the right care, at the
right time, and in the right setting.
By identifying meaningful quality differences using metrics from
the National Committee for Quality Assurance’s Healthcare
Effectiveness Data and Information Set (HEDIS) related to
preventive care and chronic conditions, the study showed patients
treated under global capitation compared to FFS:
- Were screened at higher rates for breast cancer (80% versus
74%) and colorectal cancer (82% versus 74%).
- Demonstrated higher controlled blood sugar levels (89% versus
80%) and were given more eye exams (84% versus 74%).
- Received higher rates of functional status assessment (96%
versus 86%) and medication review (97% versus 92%).
“Global capitation benefits patients, physicians and, more
broadly, the health care system,” said Dr. Richard Migliori, chief
medical officer, UnitedHealth Group. “Patients benefit because
their doctors prioritize preventive care to keep them healthy and
out of the hospital. Meanwhile, providers can offer valuable
services that may not be paid for under fee-for-service. These
findings underscore the importance of value-based care as a key
element in building a better performing health care system for
everyone.”
The analysis of more than 5 million UnitedHealthcare Medicare
Advantage enrollees and tens of thousands of primary care physician
practices concluded that physicians paid under capitation are
better positioned to:
- Prioritize preventive services and care management
programs.
- Spend more time engaging with patients.
- Use evidence-based clinical guidance.
- Avoid unnecessary patient interventions.
- Focus on keeping patients out of the hospital.
UnitedHealth Group has a long-standing commitment to promoting
and incenting value-based care. Optum works with providers and
across the country to move from fee-for-service to value-based
care, creating new choices for patients, delivering higher quality,
lower cost sites of service, customizing payment models with
payers, and supporting physicians to focus more on delivering
care.
Through UnitedHealthcare’s value-based partnerships and strong
provider relationships, physicians continue to progress toward use
of risk-based payment models, including capitation. Today,
UnitedHealthcare works with more than 113,000 physicians and 1,200
hospitals in some form of value-based relationship, including more
than 1,250 accountable care organizations. The company’s
collaboration with these providers delivers meaningful results and
better health outcomes to more than 17 million members.
About UnitedHealth Group
UnitedHealth Group (NYSE: UNH) is a diversified health care
company dedicated to helping people live healthier lives and
helping to make the health system work better for everyone.
UnitedHealth Group offers a broad spectrum of products and services
through two distinct platforms: UnitedHealthcare, which provides
health care coverage and benefits services; and Optum, which
provides information and technology-enabled health services. For
more information, visit UnitedHealth Group at
www.unitedhealthgroup.com or follow @UnitedHealthGrp on
Twitter.
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version on businesswire.com: https://www.businesswire.com/news/home/20200811005082/en/
Media Contact: Bryan Fisher, 202-292-1456,
Bryan.Fisher@uhg.com
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