News on Wellness

UnitedHealthcare and Advocate Join Forces to Create ACOs

UnitedHealthcareUnitedHealthcare announced plans to create Accountable Care Organizations (ACOs) with Advocate Health Care and Illinois Health Partners. With this, coordinated care would be provided to over 65,000 residents living in the state of Illinois, those enrolled in UnitedHealthcare’s Medicare Advantage plans.

Accountable Care Organizations (ACOs) are unique organizations comprised of insurers, hospitals, medical clinics, doctors, and other healthcare providers who come together to coordinate care with the ultimate goal of earning extra money if saving on Medicare money while staying on top of patients’ health.

Under the Affordable Care Act, these voluntary networks have strongly been encouraged to participate, with anticipation it will help an inefficient payment system currently designed to reward more care, not always better care, to include examinations and tests deemed unnecessary.

According to a representative for UnitedHealthcare, the second largest health insurer in Illinois, the plan is to share incentives and data with Advocate Health Care and Illinois Health Partners. The goal of these two distinct partnerships is to bridge the gap between care and making sure that beneficiaries get needed care at the right time but also in the right setting.

As stated by Colleen Van Ham, president and CEO of UnitedHealthCare, the collaboration with Advocate Health Care and Illinois Health Partners will have three primary effects. First, it will improve health among the Illinois population, second it will improve patient experience, and third, it will provide the best outcome while also reducing the high cost of medical costs.

UnitedHealthcare will share in any cost savings from better and higher quality managed care. People enrolled in Medicare Advantage plans associated with UnitedHealthcare and who plan to get care from providers associated with Advocate Health Care of Illinois Health Partners, are not required to do anything to receive benefits from this collaborative effort, although benefits are not guaranteed. According to the rules, providers linked to an ACO must alert their patients.

Just last week, the Centers for Medicare and Medicaid Services announced that about 25% of the 243 groups of doctors and hospitals who connected nationwide as ACOs under the Affordable Care Act did in fact save Medicare a large sum of money. So much so that combined, 64 of the ACOs received bonuses totaling $445 million.

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