Issue link: https://nebusinessmedia.uberflip.com/i/479389
2014 | Doing Business in Connecticut 79 SPONSORED REPORT Affordable means accountable The passage of the Affordable Care Act (ACA) in 2010 introduced significant changes to the way health care is delivered, which affect payers, providers, employers and consumers. One of the most funda- mental changes is the way health care is reimbursed by the Centers for Medicare & Medicaid Services, the single largest payer of health care in the United States, which is implementing more programs that encour- age health care quality over quantity. "We're moving with how the federal government is expecting to pay, and that's to get away from just paying for doing and now really paying for outcomes," said Bill Golden, CEO of UnitedHealthcare Northeast. In the past, health care providers were reimbursed by public and private payers on a fee-for-service basis that rewarded quantity of medical interventions regardless of outcome. The result has been escalating health care costs, viewed by all as unsustain- able. The new value-based reimbursement models — including accountable care orga- nizations — focus on accountability, reward- ing providers who deliver cost-effective, quality care. UnitedHealthcare and other health benefits and insurance companies are moving in this direction. All told, today, more than $30 billion of UnitedHealthcare's reimbursements to hospitals, physicians and ancillary care pro- viders are tied to accountable care programs, centers of excellence and performance- based programs. Nearly 9 million members visit physicians who are engaged in value- based contracts — 2 million of which are in accountable care/coordinated care models. By 2018, UnitedHealthcare's accountable care contracts are expected to total $65 billion, half of its annual network spend. "Moving quickly and effectively to those types of payments is a competitive advantage for us," said Golden. Modernizing health care More than 70 percent of UnitedHealth- care members in Connecticut are covered through employer-sponsored and individual plans. It is the benefits provider for some of the largest companies in the state, and the world, while also providing health benefits to more than 7,100 small businesses across Connecti- cut through its Oxford-branded plans. For Connecticut businesses of all sizes, the ever-increasing cost of providing health care benefits has been a significant challenge, slowing growth and depressing economic vitality. UnitedHealthcare's stra- tegic vision is to reverse this trend through the modernized health plan. "Our business plan in Connecticut is to use innovation, engagement and align- ment to achieve higher-quality, lower-cost care while improving the overall patient experience," said Farrell. "We collaborate with physicians, individuals and even em- ployers to encourage members to address health concerns and enhance wellness. We align incentives toward the attainment of health goals, whether it be premium savings for individuals or shared savings for physicians, for example. And then we provide each the tools and the data they need to reach these goals." UnitedHealthcare plan sponsors who have adopted the modernized health plan have already experienced positive results, reducing annual health care costs per per- son and increasing employee productivity. The United Health Foundation's America's Health Rankings®: A Call to Action for Individuals & Their Communities is an annual comprehensive assessment of the nation's health on a state-by-state basis. Published jointly by United Health Foundation, American Public Health Association and Partnership for Prevention, the rankings is the longest-running report of its kind. The 2014 report will mark the 25th anniversary of this health assessment. TOP FIVE HEALTHIEST STATES: 1. Hawaii 2. Vermont 3. Minnesota 4. Massachusetts 5. New Hampshire 2013 EDITION DIABETES PHYSICAL INACTIVITY HIGH SCHOOL GRADUATION DISPARITY IN HEALTH STATUS more of high school graduates report being in very good or excellent health compared to those who did not graduate SMOKING OBESITY Connecticut RANK: 7 no change 2012 Rank: 7 Unchanged compared to 1 in 10 nationally people in Connecticut have diabetes 1 in 11 compared to 22.9% nationally 1 in 5 22.1% or about adults in Connecticut are physically inactive nation Connecticut of students in Connecticut graduate within 4 years compared to 78.2% nationally 75.1% 33.4% Healthy People 2020 Goal: 12% of people in Connecticut smoke compared to 19.6% nationally 16.0% of adults in Connecticut are obese compared to 27.6% nationally 25.6% Continued on next page >