Friday, July 19, 2013

One way to modernize our health care system…change how we pay

The doctor with the healthiest patients may actually get paid the least amount of money.

That’s because the current “fee–for-service” payment model means that physicians and health care centers get paid each time someone visits a physician or undergoes a test or procedure regardless of the outcome.

Seems backward, doesn’t it?  Many physicians think so. 

Ruth Benton, CEO of Denver-based New West Physicians, put it this way:  “Physicians have increasingly decided that the current fee-for-service model is not sustainable in the long term, but they want payment models that are more customized to meet their specific needs. One size certainly doesn’t fit all, and UnitedHealthcare has worked with us closely to create a model that provides financial incentives and infrastructure support for delivering evidence-based high-quality care.”

That’s why UnitedHealthcare is moving away from contracts that reward the volume of care and replacing them with contracts that reward the value of care.

Currently, more than $20 billion of our reimbursements to hospitals, physicians and ancillary care providers are paid through contracts that link a portion of the reimbursement to quality and cost-efficiency measures.  But as you may have heard in the news recently, we are planning to more than double that number to $50 billion by 2017 as more care providers join the transition to accountable care contracts.

UnitedHealthcare’s accountable care strategy includes three categories of programs that offer varying levels of integration with care providers depending on their ability to assume financial risk and affect health outcomes. The level of shared accountability and financial risk between UnitedHealthcare and care providers increases with each of the three programs and the results so far are promising:

Performance-based Programs have demonstrated improved quality and cost-efficiency outcomes such as a 14% reduction in the use of non-Tier 1 prescriptions and a 25% reduction in the use of out-of-network laboratory services.

The transplant Centers of Excellence program has demonstrated a 25% reduction in average length of hospital stays for transplant patients, a 16% reduction in transplants due to applying evidence-based care approaches and improved transplant survival rates at Centers of Excellence.

Accountable Care Programs have proven results that demonstrate improved health outcomes, such as a 4 to 4.5% reduction in medical cost trend, a 16% reduction in emergency room visits and a 17% reduction in inpatient days, in addition to clinical quality results trending above program targets on 95 percent of all measures.

For more information about how UnitedHealthcare is modernizing our health care system by helping to transform the way health care is delivered, paid for and rewarded, visit

Friday, July 12, 2013

Union Beach kids design dream playground

When I think of healthy kids, I think of kids playing at their local playground, full of energy, swinging on swings, climbing up rope ladders, and sliding down circular, tunneled sliding boards.

Playgrounds give kids the chance to keep their bodies healthy while using their imaginations to do what they do best: play.

Fence in Union Beach, about a block away from
Scholer Park, where we will be building the playground
Unfortunately, many of the local playgrounds here in New Jersey were damaged in Superstorm Sandy and are no longer safe for children.  Municipalities, struggling to restore the homes and infrastructure, have little time or financial resources to rebuild their playgrounds.

That’s why UnitedHealthcare teamed up with KaBOOM! and the Borough of Union Beach to rebuild one of our local playgrounds at Scholer Park.

But we aren’t just rebuilding the old playground – we are asking the kids to tell us how we can turn it into their dream playground.

Memorial School students brainstorming
ideas together for new playground
On July 9, we hosted Design Day for Union Beach children at Memorial School to give the kids a chance to show us what their dream playground would look like.  Kids pulled out their crayons, colored pencils, and markers to illustrate their idea of a great place to play.  Elements from the drawings will be incorporated into the final design for the new community playground.

The playground will be built on September 17 by UnitedHealthcare employee volunteers with help from KaBOOM! playground experts.  In fact, the Union Beach playground marks the 11th playground built through our partnership with KaBOOM! as part of our employee volunteer initiative “Do Good. Live Well.”  The initiative aims to encourage service among our employees while promoting healthy lifestyles in the community.

As the residents of Union Beach continue their recovery and demonstrate how they are “stronger than the storm”, we hope that the playground will be a bright spot for families to enjoy healthy outdoor play.

Students show off their dream designs for new
playground coming to Union Beach in September

Monday, July 1, 2013

New Jersey ranks 27th in the country for seniors’ health

Back in December, I was proud to write that New Jersey had worked its way up to the 8th healthiest state in the U.S. according to United Health Foundation’s annual America’s Health Rankings.

But while the overall health of our state has improved, the news is not so good for our senior population based on United Health Foundation’s most recently published report which focused on the health of Americans age 65 and older.  In this report, New Jersey came in at number 27.

The report ranked the states based on 34 different elements, some of which New Jersey was among the best in the nation, and others where we were at the bottom.

New Jersey’s strengths:
·         Recommended hospital care: New Jersey ranks 3rd in the nation with 98.3% percent of seniors receiving the appropriate hospital care recommended by their doctors for conditions such as heart attack, heart failure and pneumonia.
·         Able-bodied seniors: 66.8% of New Jersey seniors are considered able-bodied, the 6th best rate in the country.
·         Availability of geriatricians: New Jersey ranks 8th in the nation for having enough geriatricians to meet the needs of the elderly, although New Jersey still has a shortfall 41.8% of needed geriatricians.

New Jersey’s weaknesses:
·         ICU usage: 24.7 percent of New Jersey seniors spend 7 days or more in an intensive care unit during the last 6 months of life, the worst rate in the country.
·         Hospital deaths: 36.7 percent of New Jersey residents age 65 or older die in the hospital, the 4th worst rate in the U.S.
·         Hospital readmissions: 16.8 percent of hospitalized patients age 65 or older were readmitted to the hospital within 30 days of discharge, placing New Jersey 46th among the states.

As a whole, Americans are living longer but sicker lives.  About 80 percent of seniors live with at least one chronic health condition, and 50 percent live with two or more chronic health conditions, according to the Centers for Disease Control and Prevention

Medicare beneficiaries can take advantage of UnitedHealthcare’s programs that are designed to make it easier for seniors to get the care they need.  For example, we support integrated disease management and care coordination  programs, which provide select Medicare Advantage Plan members with chronic health conditions such as diabetes or heart disease with the needed resources and support.

UnitedHealthcare also offers the HouseCalls program and PharmAssist service.  HouseCalls offers qualified Medicare Advantage plan members an at-home visit with a health care practitioner to assess health needs and discuss personal health concerns.  The PharmAssist services provides one-on-one counseling sessions with specialty-trained plan pharmacists to help seniors understand how to take their medication correctly as prescribed.

The America’s Health Rankings Senior Report is the most comprehensive rankings to date of senior health on state and national levels, and it highlights some of the most critical health issues facing our seniors.   For more information, you can view and download the report at