Catalyst and UnitedHealthcare ACO Lowers Healthcare Costs by $28 Million in Two Years

| URAC Staff
Hand of doctor using a calculator for medical costs in hospital

Catalyst Health Network (Catalyst) and UnitedHealthcare’s accountable care organization (ACO) has improved the number of annual preventive screenings year over year for cervical cancer, breast cancer and colorectal cancer, and lowered healthcare costs in North Texas by more than $28 million in the last two years.

In addition to quality improvements, savings were also driven by an 11 percent increase in specialist referrals to in-network providers and a four percent reduction in emergency room visits.

This accountable care relationship, established in 2015 for people enrolled in UnitedHealthcare employer-sponsored and individual health plans, has grown to include more than 500 care providers across North Texas.

Touching the lives of thousands of UnitedHealthcare plan participants through preventive screenings in the last year, the ACO has seen these improvements in annual cancer screenings:

  • 6,300 patients annually have received colorectal cancer screenings, compared to 5,800 before the ACO, an increase of more than 8 percent;
  • 3,400 patients annually have received breast cancer screenings, compared to 3,100, an increase of nearly eight percent; and
  • 8,800 patients have received cervical cancer screenings, compared to 8,500, an increase of three percent.

A clinically integrated network of primary physicians, Catalyst achieved URAC Clinical Integration Accreditation in December 2017. With 515 primary care providers, 160 office locations, 800,000 patients, and 70 care team members, Catalyst operates as a non-profit organization improving health, coordinating care, and lowering cost – creating sustainable and predictable value.

Accountable care programs offer a care delivery model that shifts care provider reimbursement away from the traditional fee-for-service delivery model to a value-based approach in which physicians are eligible to receive payment incentives based on patient satisfaction and achieving certain clinical measures. This collaboration also improves the ability to identify patients who are at high risk and helps them reduce emergency-room visits and readmissions to the hospital, manage their chronic health conditions and take their needed medications.

Learn more about how the process of URAC Clinical Integration Accreditation helped Catalyst improve the organization and demonstrate their commitment to quality healthcare and accountability, in a free on-demand webinar, “How Three Clinically Integrated Networks Achieved Measurable Benefits from the Accreditation Process.”

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