WESTMED Medical Group announced it is collaborating with the UnitedHealthcare and Optum businesses of UnitedHealth Group (NYSE: UNH) to launch an accountable care organization (ACO) for its more than 220 physicians in Westchester County, N.Y.
“Our collaboration with WESTMED is the latest in a series of accountable care initiatives that bring together the strength of UnitedHealthcare's care provider networks and Optum's technology capabilities to further advance patient care and service.”
Collaborating with UnitedHealthcare will enable WESTMED physicians to be eligible for incentives based on measurements in disease management and prevention, patient safety, and appropriate care utilization. Participating physicians will be measured and rewarded based on quality health outcomes, patient satisfaction and reduction of medical costs in the Westchester market to below current, trend-adjusted levels. Bonus eligibility requires that both care quality and cost metrics are achieved concurrently to help ensure that physicians focus on providing the right level of care for patients.
WESTMED Medical Group, based in Purchase, N.Y., is a large multispecialty group medical practice staffed by more than 220 physicians that provide coordinated, efficient, quality care at its nine locations in central and lower Westchester County. Its patient-centered medical home program has received the highest level of recognition (Level 3) from the National Committee for Quality Assurance (NCQA) for providing coordinated, efficient and quality primary care. NCQA is a nonprofit organization dedicated to improving health care quality.
WESTMED physicians will use Optum's analytical tools to help identify best practices for overall patient wellness and disease management, and measure their own performance in these areas over time. Participating physicians will have access to advanced tools and software applications that provide physicians and other health professionals access to detailed health intelligence on patient, system and population health, enabling them to collaborate on medical care decisions and improve health outcomes.
These capabilities will help ensure that evidence-based guidelines and other information are available to support decisions at the point of care, and that important patient health information is shared effectively and securely among care providers.
"The entire health care delivery system is becoming more oriented toward collaborating and sharing accountability for patient health. Partnering with UnitedHealthcare and Optum to improve across all areas of our practice is the next step in our evolution to provide best-in-class care to our patients, reduce total medical costs and increase patient satisfaction across the region," said Simeon Schwartz, M.D., president and CEO of WESTMED.
"UnitedHealthcare has extensive experience working with health care providers on quality- and efficiency-based reimbursement models that improve care while decreasing health care costs," said Sam Ho, M.D., executive vice president and chief medical officer of UnitedHealthcare. "Our collaboration with WESTMED is the latest in a series of accountable care initiatives that bring together the strength of UnitedHealthcare's care provider networks and Optum's technology capabilities to further advance patient care and service."
"Our in-depth capabilities drive toward a clear goal: supporting a health system that is simpler and more intelligent," said Todd C. Cozzens, CEO of Optum Accountable Care Solutions.
The WESTMED ACO initially applies to UnitedHealthcare plan participants who reside in Westchester County and are covered under an Oxford Health Insurance fully insured commercial product, including its Metro, Access and Direct plans. An expanded agreement, which will include UnitedHealthcare Westchester County plan participants covered under Oxford's fully insured commercial HMO and POS products, is being filed with the New York State Department of Health for approval.
Through its UnitedHealthcare and Optum businesses, UnitedHealth Group is working with physician groups, hospitals and medical centers, and other health care delivery organizations across the country to achieve Institute for Healthcare Improvement's (IHI) "Triple Aim" objective: improving population health and patient experience, delivering the best possible quality outcomes and reducing the overall cost of care. UnitedHealth Group's value-based payment capabilities are designed to support the transformation of care delivery.
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