UHC participates in three-year project to improve quality of care and reduce overall costs

UHC will be participating in a three-year project, funded by the U.S. Department of Health & Human Services, Center for Medicare & Medicaid Services, that aims to improve the quality of care and the patient experience while reducing the overall cost of care by enhancing communication and coordination between primary care physicians and specialists. This program will be funded through round two of the Center of Medicare and Medicaid Innovation's (CMMI) Health Care Innovation Awards, which fund efforts to reduce costs, test new payment and clinical models, and improve care for patients with specialized needs.

UHC will collaborate with the Association of American Medical Colleges (AAMC), Dobson DaVanzo & Associates, and five academic medical centers (AMCs) across the country to evaluate the impact of implementation of a consultation and referral platform that is integrated into the electronic health record. The pilot project participants are UHC members Dartmouth-Hitchcock Medical Center, UC San Diego Health System, University of Iowa Hospitals and Clinics, University of Virginia Health System, and University of Wisconsin (UW) Health.

The e-consult technology, developed by the University of California, San Francisco, has been shown to significantly improve quality of care through improved coordination and timely access to specialist input, while reducing the costs of care by fewer referrals and reduced fragmentation of care. UHC will partner with the AAMC and coordinate with its participating members to evaluate the impact of the intervention on metrics such as quality, cost, access, and patient and provider satisfaction.

"Given the accelerating shift to value-based reimbursement, enhancing the efficiency and effectiveness of care delivery is critical to academic medical centers' success," says Bob Browne, MPP, UHC vice president, Clinical Enterprise Integration. "Consistent care coordination and timely access to the input of specialists through the use of e-consultation/e-referral technology is a novel way for AMCs to improve cost, quality, and access. UHC looks forward to collaborating with five of our esteemed AMC members and the AAMC to understand how this technology can have a positive impact on the future of health care delivery."

UHC's long-standing experience working with and providing strategic insights and business intelligence solutions to AMCs and their affiliated faculty practice organizations will enable it to evaluate how the research findings may positively influence the design of future care delivery processes nationally. UHC will also contribute its expertise in data analytics to support the project's objectives.

Dobson DaVanzo & Associates, a Washington, DC-based health economics and policy consulting firm, will assist in creating a payment model for consideration by the Centers for Medicare & Medicaid Services to sustain and scale this innovation beyond the award period.