New Way to Pay Doctors

UnitedHealth, Nation's Largest Insurer, Is Latest to Announce Fee Overhaul

As reported in the Wall Street Journal, UnitedHealth Group, Inc has announced plans to introduce contracts nationwide that will overhaul the reimbursement structure for medical providers and hospitals. With more than 5,500  hospitals and 550,000 doctors in its network, this represents a significant change for this carrier.Currently, UnitedHealth compensates health providers on a fee-for-service basis, which rewards increased patient volume, but not necessarily improved quality of care. UnitedHealth plans to diversify the models used in its new contracts. New plans could tie compensation to reduced hospital readmissions and increased participation in recommended screenings among patients while others might focus on patient satisfaction and total patient care costs. Cost projections predict savings at twice the amount of costs associated with this new payment structure. Provider participation is expected to be voluntary as the carrier works on incentivizing providers through bonuses directly tied to program goals as well as 'clinical integration' fees used in models of 'patient-centered medical homes' that would offer compensation to health providers utilizing improved practices of patient tracking and care coordination.

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