Rewarding Quality and Excellence in Medical Care

UnitedHealthcare - doctor-patientIf you have ever sat in on a healthcare treatment discussion among knowledgeable and well-respected medical professionals, you almost certainly have heard differences of opinion about how to treat certain conditions and even what those conditions may be.

Quality medical care is and should be built around the latest scientific advances, regular screenings, medication adherence, model treatment plans and, of course, prevention. All of these practices contribute to better outcomes and healthier lives.

This month, UnitedHealthcare honored more than 350 Texas health care professionals for taking such an approach with their patients.

UnitedHealthcare’s “PATH Excellence in Patient Service Awards” were based on the achievement of several quality standards and successfully closing gaps in care for UnitedHealthcare’s Medicare Advantage members.

The PATH program annually rewards physicians who meet certain performance-based criteria, including achieving or exceeding 17 specific Healthcare Effectiveness Data and Information Set (HEDIS) measures, used by the Centers for Medicare & Medicaid Services and many health plans. For example, HEDIS measures include the percentage of eligible UnitedHealthcare Medicare Advantage members who receive breast or colorectal cancer screenings, as well as the percentage of members who adhere to their medications that help manage diabetes, high blood pressure or cholesterol.

In addition to being recognized for their excellence, the PATH award winners in Texas also shared $2.9 million in bonus payments.

“We are committed to recognizing and rewarding physicians in Texas for consistently helping our plan participants live healthier lives,” said Sam Ho, M.D., chief medical officer of UnitedHealthcare. “As UnitedHealthcare continues building deeper, more collaborative relationships with care providers, the PATH Excellence in Patient Service Awards are just one step we are taking to support the transition to a value-based health care system in which payment is increasingly based on ensuring the people we serve receive the quality care they need.”

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, which tend to become more common as people age. According to the Centers for Disease Control and Prevention, fewer than half of Americans 65 and older were up to date on core preventative services such as tests and screenings, even though they were getting regular medical checkups.

The program provides support and incentives for physicians and other healthcare providers, as well as the Medicare Advantage members themselves to be engaged in their own health care and take action on their doctors’ treatment plan, thereby preventing some conditions and identifying others before they lead to more difficult complications.

Nearly 1 million UnitedHealthcare Medicare Advantage members around the nation 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. For more information about UnitedHealthcare’s full spectrum of value-based initiatives, visit www.AccountableCareAnswers.com.

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