By DP Opinion
By Beth Soberg and Ruth Benton
Colorado, like the rest of the country, faces challenges in improving access to quality care and managing costs. A recent study from the New America Foundation and the University of Denver suggests Colorado’s health care costs are the seventh highest in the nation, and if we fail to act, those costs will continue to grow at twice the rate of the overall economy. Our state requires thoughtful, practical solutions that not only expand access and strengthen care, but lower costs as well.
UnitedHealthcare and New West Physicians have partnered to form a collaborative model for health care payment and delivery that will enhance care for people in metro Denver insured through UnitedHealthcare employer-sponsored plans. The model, called an accountable care organization (ACO), enables primary care doctors to manage all aspects of health care so that the proper course of treatment is being followed.
ACOs represent a departure from the traditional health care model of rewarding the volume of patients treated to rewarding quality of care and positive health outcomes. By achieving a triple objective – increased patient satisfaction, improved population health, and reduced health care costs – the goal is to move the delivery system toward increased collaboration within the health care community, with a greater emphasis on shared risk and accountability for improved outcomes.
To get a sense of how this would work, consider a patient being treated for heart disease. Under an ACO, all the tests, screenings and medications the patient receives will be collected into one record that the patient’s care providers can easily access, so that the appropriate course of care occurs, the care is coordinated, and the patient receives any and all necessary services.
The ACO model will also help manage services for patients with chronic conditions, such as diabetes and heart disease, while keeping the focus on health and well-being, increased patient safety and care delivery well-supported by science.
This type of collaboration begins with health insurers and care providers, but ends with better health outcomes for patients and lower costs for their employers. The system works by offering care providers tools to help identify best practices for overall patient wellness and disease management, and measure their own performance in these areas over time. In return, insurers provide financial incentives based on meaningful improvements in specific categories such as readmission rates, disease management and prevention, patient safety and appropriate care utilization.
As employers look to stretch their health care dollars, they should look for plans that include access to an ACO, or other types of models that offer better care at lower costs. ACOs are a win for patients and for employers who will see more value from the money they put toward employee health care premiums.
Expanding ACOs will mark just one step in the evolution of health care delivery, but it is creative solutions like these that are forming meaningful, new partnerships and developing products to ensure that everyone in metro Denver has access to affordable, quality health care.
Beth Soberg is CEO of UnitedHealthcare of Colorado. Ruth Benton is CEO of New West Physicians.