UnitedHealth expects 150M members to be in value-based programs by 2025

UnitedHealthcare
UnitedHealth CEO David Wichmann said the insurer is "not satisfied with the status quo" of rising healthcare costs. (jetcityimage/Getty)

UnitedHealth expects at least 150 million members will be in value-based coordinated care programs by 2025, the company's CEO said on Thursday.

Shepherding providers into value-based payments is one of the insurer’s three fundamental goals to help modernize the healthcare system, CEO David Wichmann told investors at Bernstein Research’s Annual Strategic Decisions Conference on Thursday. Currently, 15 million UnitedHealthcare members across the country receive care from physicians in value-based contracts, and the insurer aims to increase that figure 10-fold over the next seven years.

“We are not satisfied with the status quo,” Wichmann said, pointing to rising healthcare costs as well as data that shows UnitedHealth’s value-based contracts have reduced hospitalizations by 17% and cut overall costs by as much as 8%.

Webinar

Breaking Through the Barriers to Better CX

Please join this webinar to learn how health plans can streamline member engagement and prioritize cross-departmental goals by leveraging CX technology.

The insurer is also focused on diverting care to the appropriate site, namely away from the emergency department and through its growing health services arm, Optum Care. Wichmann said UnitedHealth wants Optum Care to be the “preeminent” ambulatory services organization in the country, which the insurer can use to nurture its shift toward value over volume. 

UnitedHealth is also building up its bench of digital tools to provide customers with more information about their health, either by controlling chronic conditions or putting drug-pricing information in front of patients.

From a drug-pricing perspective, UnitedHealth rolled out a plan earlier this year to offer point-of-sale rebates to about 7 million members, a move that got the approval of Department of Health and Human Services Secretary Alex Azar.  

RELATED: Health insurer groups speak out against Medicare Part D policy proposal

While Wichmann said he is “supportive” of point-of-sale discounts, rolling that policy out in the Part D program can be problematic. The Centers for Medicare & Medicaid Services (CMS) received 1,400 comments after soliciting comment on a potential policy shift that would have applied manufacturer rebates at the point of sale. Insurers argued that the move would increase premiums. 

“There are consequences to it, including consequences to the federal budget and consumer premiums,” Wichmann said. “Those need to be well understood and appropriate measures need to be taken to minimize that.”

Wichmann supports single payer, with some caveats

With some Democrats backing a single-payer healthcare model in the upcoming midterms, Wichmann said he is supportive of policies that ensure more Americans have health coverage.

RELATED: As centrist Democrats warm to government-sponsored healthcare, their road to single payer remains icy

“There’s speculation about what a single-payer system is and what exactly does that mean,” he said. “If that means universal coverage, which is what I hear when I start to break that question down, yes we are supportive of that.”

Unsurprisingly, however, Wichmann was less supportive of that policy if it involved government-sponsored plans rather than funneling coverage through private insurers.

“I don’t know you find a lot of support of that broadly,” he said of the government-sponsored approach.

Government-sponsored plans have been a boon for the company. Last quarter, UnitedHealth reported a 28.7% increase in net earnings, with Medicare Advantage plans as a primary driver.

Suggested Articles

Humana has filed suit against the Trump administration over cost-sharing reduction payments.

CMS needs to press Congress to be able to penalize hospitals that submit incorrect wage data, according to one of recommendations in an OIG report.

The Trump administration has launched a new alternative payment model to provide upfront investments to rural healthcare providers.