UnitedHealth Group to support Medicare bundled payment program with analytics, care coordination

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UnitedHealth Group is gearing up to participate in the new bundled payment models launched by CMS last month. (Image: UnitedHealth)

UnitedHealth Group plans to provide the technical infrastructure and the provider network to support Medicare bundled payment models scheduled to begin later this year.

The insurer said it plans to provide data analytics, technology and care coordination to assist providers participating in the Centers for Medicare and Medicaid Services (CMS) Bundled Payment for Care Improvement (BPCI) Advanced program that includes financial rewards for providers exceed quality standards for specific treatments, such as joint replacements. UnitedHealth will offer its analytics capabilities to providers to help improve quality outcomes, according to Thursday’s announcement.

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UnitedHealth is in the process of building a network of care providers required to be BPCI Advanced convener. CMS launched that payment model last month, just two months after it canceled two mandatory bundled payment models established under the Obama administration.

The BPCI Advanced model—the first value-based arrangement launched by the Trump administration—includes 32 clinical care episodes aimed at incentivizing providers to “deliver efficient, high-quality care,” CMS Administrator Seema Verma said when the initiative was announced in January.

The first cohort of participants in the program will begin on Oct. 1, 2018.

Data analytics capabilities are poised to play a critical role in that shift to drive care coordination and quality improvement and identify opportunities to cut costs. Other insurers like Oscar and Humana have been beefing up their infrastructure to meet that demand.

Still, a recent survey of healthcare financial executives indicated that a lack of interoperability is a major barrier to value-based care. Another recent survey shows physicians are becoming more comfortable with value-based reimbursement, but a number of key barriers have also generated significant skepticism.