The Value-Based Care Reimbursement Program Through UnitedHealth Improves Patient Outcomes

unitedhealth care reimbursement programUnitedHealth is one of the payers that officially adopted the value-based care network reimbursement program within their network of providers. This has promoted reforms in payments and has reduced the amount of medical-based spending. The new models being utilized by the payer is coming directly from public-based payers, such as the Centers for Medicare & Medicaid Services (CMS).

This center has a goal of having – at least – half of all of the Medicare payments to be part of the alternative payment models that have been in the works by the end of 2018. It believes that value-based care network reimbursement is the optimal payment model for medical providers – such as physical therapists. To date, UnitedHealth is operating approximately 1/3 of all of the Medicare-based payments within the value-based models.

Traditionally, providers that serve as payers have utilized a fee-for-service reimbursement type of model. Unfortunately, this model has resulted in the excessive usage of medical care services, testing that is considered to be unnecessary, and a vast array of spending that is considered to be exceptionally wasteful.

As a result, the healthcare industry has been moving towards ways to reduce costs within the medical field. One of the methods used to reform the finances of the healthcare industry is the value-based care network reimbursement program. In fact, this alternative payment methodology has been a major part of the financial reform.

UnitedHealth made an official announcement in August 2016 that they had awarded 1,900 different providers with the PATH Excellent in Patient Service Awards. These groups use the value-based care network reimbursement program to successful improve the outcomes of their patients that were officially enrolled in the Medicare Advantage program plans.

In addition to the awards provided to the medical professionals, there was an additional $148 million in bonuses given to the providers. These bonuses were issued because the providers met the performance metrics outlined in the PATH Program. This was created to ensure that providers gave their patients preventive services and that they increased the monitoring of patients that suffered from medical conditions.

The purpose and intent of a value-based care network is to ensure that providers are committed to improving patients’ overall health. Each patient is able to reach the highest level of well-being through the network. Quality care is awarded over unnecessary quantity care. Examples of services that are awarded are screenings for breast cancer, colorectal cancer, and similar complications. In addition, patients that have diabetes are provided with eye examinations.

Patients are provided with information on what types of physical activities will benefit their health and are encouraged to improve their physical fitness levels. Finally, patients are provided with services and various types of medications that are considered ideal for individuals their age. Value-based care network reimbursements are making a difference in the medical field and a difference in the lives of patients.

If you would like to learn more about value-based networks, the reimbursements associated with the networks, and alternative methodologies, start on our Home Page
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