Doctors Earn More Than $148 Million in Quality of Care Bonus Payments for Improving Health Outcomes, Addressing … – Digital Journal

MINNETONKA, Minn.–(Business Wire)–UnitedHealthcare recently recognized more than 1,900 care providers with
the 2015 UnitedHealthcare PATH Excellence in Patient Service Awards for
their commitment to improving health outcomes for people enrolled in its
Medicare Advantage plans.

These care providers earned more than $148 million in quality of care
bonus payments for achieving performance metrics in the UnitedHealthcare
PATH Program and successfully addressing care opportunities when
treating UnitedHealthcare’s Medicare Advantage members.

UnitedHealthcare created the PATH program to help people enrolled in its
Medicare Advantage plans be as healthy as possible by encouraging
greater use of preventive health care services and proactive monitoring
of chronic conditions.

The program annually rewards physicians who meet certain
performance-based criteria, including achieving or exceeding targets
established by the Centers for Medicare & Medicaid Services (CMS) for
specific Healthcare Effectiveness Data and Information Set (HEDIS)
measures. Health plans and CMS use HEDIS as a tool to measure
performance on important dimensions of health care and service.

Examples of the quality measures used to evaluate care providers’
performance in the 2015 PATH program include:

  • the percentages of eligible UnitedHealthcare Medicare Advantage
    members who received a breast cancer screening or colorectal cancer
  • 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.

By achieving the PATH program’s performance metrics, care providers also
proactively addressed care opportunities for UnitedHealthcare’s Medicare
Advantage members. A care opportunity exists when an individual hasn’t
received a health care service or medication recommended based on his or
her age or health status. In 2015, care providers participating in the
PATH program addressed nearly 1.8 million care opportunities for
UnitedHealthcare’s Medicare Advantage members.

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

“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. “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.”

The PATH program provides support and incentives for both care providers
and Medicare Advantage members to enhance their engagement in their
health care and willingness to take action on their doctors’ treatment
plan. The program has four components:

1. Patient support and communication
2. Actionable patient data and
3. Financial compensation for doctors
4. Support for
physician practices to enhance care coordination

The PATH program is part of UnitedHealthcare’s commitment to help shift
the nation’s health care system to one that rewards quality and value
instead of the volume of procedures performed. To facilitate this shift,
the company offers a variety of value-based payment arrangements,
including incentive programs like PATH, performance-based contracting,
bundled payments and fully integrated accountable care organization
(ACO) relationships.

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 tripled in the
last three years to $48 billion. By the end of 2018, UnitedHealthcare
expects that figure to reach $65 billion.

For more information about the PATH program and UnitedHealthcare’s full
spectrum of value-based initiatives, visit

Serving one in five Medicare beneficiaries, UnitedHealthcare is the
largest business dedicated to the health and well-being needs of seniors
and other Medicare beneficiaries.

About 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 1 million 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
or follow @myUHC on Twitter.

All statistics throughout this press release can be attributed to
internal 2016 UnitedHealthcare data.

Plans are insured through UnitedHealthcare Insurance Company or one of
its affiliated companies, a Medicare Advantage organization with a
Medicare contract. Enrollment in the plan depends on the plan’s contract
renewal with Medicare. This information is not a complete description of
benefits. Contact the plan for more information. Limitations,
co-payments, and restrictions may apply. Benefits, premium and/or copayments/co-insurance
may change on January 1 of each year.

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Sarah Bearce, 952-406-5615


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