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Health Reward Stat of the Day – July 22

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UnitedHealthcare recently awarded more than $54 million in bonus payments to more than 4,000 care providers named winners of the PATH Excellence in Patient Service Awards.*

The recipients achieved the highest adherence levels for key quality measures by successfully closing gaps in care when treating UnitedHealthcare Medicare Advantage members.

The PATH program annually rewards physicians who meet certain performance-based criteria, including achieving or exceeding compliance targets for 17 specific Healthcare Effectiveness Data and Information Set (HEDIS) measures, including the percentages of eligible UnitedHealthcare Medicare Advantage members who received a breast cancer screening or colorectal cancer screening. Other measures evaluate the percentages of members who adhere to their medications to help manage their diabetes, high blood pressure or cholesterol.

In 2015, nearly 1 million UnitedHealthcare Medicare Advantage members are being treated by doctors who participate in the PATH program.*

Health plans and the Centers for Medicare & Medicaid Services use HEDIS as a tool to measure performance on important dimensions of health care and service.

UnitedHealthcare created the PATH program to help its Medicare Advantage members be as healthy as possible by encouraging greater use of preventive health care services and proactive monitoring of chronic conditions. The 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, thereby closing gaps in care.

The PATH program has four components:

Patient Support and Communication: UnitedHealthcare supplements care providers’ patient engagement efforts through comprehensive communications to educate Medicare Advantage members about the importance of taking proactive steps to keep their health on track. Mailings, emails and phone calls to members emphasize the importance of working with their doctors to create a personalized preventive care plan as well as getting their annual care visit and any recommended tests and screenings. Reminders and financial incentives offer further encouragement to follow through on scheduling appointments and tests.

Actionable Patient Data and Reporting: UnitedHealthcare provides participating care providers with monthly Patient Care Opportunity Reports that include detailed patient-level and practice-level data in a format that is easy to use. The data facilitate the delivery of coordinated care by giving care providers a more complete picture of their patients’ health, including their hospitalizations, care they receive from other doctors and adherence to prescribed medications. On an ongoing basis, care providers can see at a glance the number of UnitedHealthcare Medicare Advantage patients who are overdue for an annual care visit or cancer screenings, for example, so they can take action to engage these patients and close their gaps in care.

Financial Compensation for Doctors: Because this type of patient engagement can require extra effort on the part of care providers, the PATH program offers financial compensation to care providers who exceed quality-based performance targets. Care providers who improve specific HEDIS measures for eligible UnitedHealthcare Medicare Advantage members can earn an annual bonus payment.

Practice-Based Support: UnitedHealthcare collaborates with care providers to provide additional tools, resources and support that can help facilitate care coordination and improve health outcomes. Given that every practice is different and has unique needs, UnitedHealthcare engages with practices in a variety of ways to offer customized support, such as joint communication efforts and on-site administrative and clinical resources.

In 2015, nearly 1 million UnitedHealthcare Medicare Advantage members are being treated by doctors who participate in the PATH program.*

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 fee-for-value payment arrangements, including incentive programs like PATH, performance-based contracting, bundled payments and accountable care organization (ACO) relationships.



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