UnitedHealthcare Awards $148 Million in Bonuses to Medicare Providers

UnitedHealthcare recently awarded more than $148 million in quality of care bonus payments to approximately 1900 care providers as part of the annual 2015 UnitedHealthcare PATH Excellence in Patient Service Awards. The awards program is intended to improve health outcomes for people enrolled in its Medicare Advantage plans.

UnitedHealthcare created the PATH program to ensure that beneficiaries enrolled in Medicare Advantage plans are as healthy as possible. The program works by encouraging greater use of preventive care services and continually monitoring chronic conditions.

Award recipients successfully addressed care opportunities while treating Medicare Advantage members who met performance metrics in the UnitedHealthcare PATH program. The metrics, established by the Centers for Medicare & Medicaid Services (CMS), are for specific Healthcare Effectiveness Data and Information Set (HEDIS) measures. CMS uses HEDIS as a method to measure performance on important dimensions of care and service.

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The PATH program has four main components to support care providers and Medicare Advantage members including, patient support and communication, actionable patient data and reporting, financial compensation for doctors, and support for physician practices to enhance care coordination.

The quality measures used to evaluate care providers in the 2015 PATH program were:

• the percentages of eligible UnitedHealthcare Medicare Advantage members who received a breast cancer screening or colorectal cancer screening;
• the percentage of members with diabetes who received an eye exam; and,
• the percentage of members who received advice from their doctor to maintain or enhance their level of physical activity.

“The care providers who earned a PATH Excellence in Patient Service Award deserve recognition for their commitment to improving our plan participants’ health and well-being,” said Efrem Castillo, M.D., chief medical officer of UnitedHealthcare Medicare & Retirement in a press release. “These awards are one of the ways we are supporting the transition to a value-based health care system that rewards physicians for the quality of care they deliver to the people we serve.”

Since the launch of the PATH program in 2013, participating care providers have earned more than $213 million in quality of care bonus payments. Approximately 1 million Medicare Advantage members are currently being treated by doctors who participate in UnitedHealth’s PATH program.

Due to care providers showing a strong interest in value-based care, UnitedHealthcare’s total payments to physicians and hospitals regarding value-based arrangements have tripled to $48 billion over the last three years. UnitedHealthcare expects total payments to reach $65 billion by 2018.

-Julie Gould

Reference:

BusinessWire. Doctors Earn More Than $148 Million in Quality of Care Bonus Payments for Improving Health Outcomes, Addressing Care Opportunities for UnitedHealthcare Medicare Advantage Members [press release]. Published August 4, 2016. Accessed August 5, 2016.