New health insurance program pays docs for keeping patients healthy

Posted Feb 6, 2013, 9:15 am

Austin McEvoy TucsonSentinel.com

A healthcare model that pays doctors for keeping their patients out of the hospital is coming to Tucson.

A new partnership between UnitedHealthcare and Arizona Connected Care has the potential to improve quality of healthcare and reduce costs for more than 180,000 Pima County residents enrolled in UnitedHealthcare's employer-sponsored plan, company officials said. AzCC is the first Accountable Care Organization in Southern Arizona.

The plan will open March 1.

AzCC first partnered with UHC's Medicaid and Medicare programs in April 2012, but this the first time that AzCC's accountable care model is being offered to patients with an employer-sponsored plan.

The goal of accountable care programs is to encourage quality over quantity when it comes to treating patients. AzCC doctors get paid for keeping their patients healthy. More than $20 billion of UHC's national budget is reserved for accountable care programs like AzCC, the company said.

"Part of the income potential is now distributed based on how good of a job we are doing at taking care of patients, not how many times we run them through the office," said Dr. Richard Johnson, AzCC's medical director.

UHC plan participants who have an AzCC provider do not need to sign up for anything in order receive the accountable care program benefits, Johnson said. They are already enrolled in the system. The expansion will not cost patients anymore money than they are paying now; it reduces healthcare costs in two major ways, he said:

• The accountable care model fosters more effective communication between a patient's doctors to help eliminate unnecessary medical testing.
• Doctors are encouraged to reach out to patients with chronic illnesses to prevent reoccurring hospital visits or Emergency Room admissions.

Patients whose doctors are a part of AzCC will see subtle changes in the way they are treated. For example, doctors may call to check-up on patients and talk to them about how they want to work on preventive care. Patients may also noticed longer clinic hours so that they can to go to their primary care doctor instead of going to an urgent care clinic, said UHC CEO Jeri Jones.

"Hopefully this plan simplifies and coordinates care better," Jones said.

Tucson Medical Center is currently the only local hospital that is participating in AzCC's plan. AzCC is also one of the few ACO's that have also partnered with federally qualified health centers. The three major health centers in Southern Arizona that AzCC has partnered with are El Rio Community Health Center, Marana Health Center, and Mariposa Community Health Center.

UHC is working with health facilities in Phoenix to introduce a similar plan, Jones said.

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Source: http://www.tucsonsentinel.com/local/report/020613_az_connected_care/new-health-insurance-program-pays-docs-keeping-patients-healthy/

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