More than 63,000 United health Care employer sponsored health plan participants in Northern California will benefit from improved care coordination and enhanced health services.
Palo Alto CA – Business wire: Palo Alto Medical Foundation (PAMF) and United Healthcare have launched an accountable care organization (ACO) to improve how patient care is coordinated and delivered for more than 63,000 Northern California residents enrolled in United Healthcare’s employer sponsored health plans.
The ACO will help shift California’s health care system to one that rewards quality and value instead of volume of procedures performed. Specifically, the ACO will transform PAMF from a fee-for-service compensation model to a value based approach in which the organization is rewarded for achieving certain evidence based measures – such as hospital readmission rates, disease management and prevention, and patient safety – as well as total cost savings.
PAMF and United Healthcare’s partnership is one of 250 new accountable care programs United Healthcare has committed to in 2015 as it engages in deeper, more collaborative relationships with physicians and hospitals across the country.
Palo Alto Medical Foundation
Palo Alto Medical Foundation is part of Sutter health, a family of not-for-profit hospitals and physician organizations that share resources and expertise to advance health care quality throughout Northern California. Founded in 1930, the PAMF is a health care organization that is a pioneer in the multi-specialty group practice of medicine, health innovation and patient-centered care.
PAMF’s more than 1,200 affiliated physicians and 5,400 employees serve nearly 850,000 patients at its medical centers and clinics in Alameda, Contra Costa, San Mateo, Santa Clara and Santa Cruz counties.
“The Sutter health network of care providers places a high value on coordinating care,” said Jeffrey Burnich, M.D., senior vice president of Medical and Market Networks at Sutter Health. “We’re excited about the potential for this new partnership to improve patient care.”
Through this collaboration, United Healthcare will complement PAMF’s own data by providing additional support to manage overall population health, including technology and information that will help the group’s more than 500 primary care physicians take specific actions that improve quality and lower costs. Actionable data may include patient profiles, specific HEDIS performance measures on care and service, and real time notification of ER and inpatient admissions.
Patient navigators may also be used to support community based care coordination, such as helping with transition plans after an individual is discharged from the hospital. This approach will enable physicians to identify best practices for overall patient wellness and disease management.
Accountable Care Organizations
Accountable Care Organizaations (ACOs) are groups of doctors, hospitals and other health care providers, who come together voluntarily to give coordinated high quality care to the patients they serve. Coordinated care helps ensure that patients, especially the chronically ill, get the right care at the right time, with the goal of avoiding unnecessary duplication of services and preventing medical errors. When an ACO succeeds in both delivering high quality care and spending health care dollars more wisely.
United Healthcare employer sponsored plan participants who currently receive care from PAMP providers will not have to do anything differently to benefit from this new relationship.
Care providers nationwide are showing strong interest in a shift to value based care. United Healthcare’s total payments to physicians and hospitals that are tied to value-based arrangements have nearly tripled in the last three years to $38 billion. By the end of 2018, United Healthcare