AUSTIN, Texas (June 27, 2013) – Seton Health Alliance, an accountable care organization (ACO), and UnitedHealthcare are collaborating to provide coordinated health care to Central Texas residents enrolled in UnitedHealthcare’s employer-sponsored health plans. The announcement was made at a videotaped news conference.
This ACO model will help shift the Central Texas’ health care system from one based on volume of patients to one that rewards quality and value. The collaboration will leverage the resources of Seton Healthcare Family, Austin Regional Clinic, Lone Star Circle of Care and community physicians to manage all aspects of patients’ health care and provide them with the right care in the right place at the right time. This will be the first commercial ACO program in Central Texas.
“Our long-term goal for Seton Health Alliance is to expand the number of care providers and develop a clinically integrated network that effectively and efficiently improves the health of our community,” said Jeff Cook, president and CEO of Seton Insurance Services. “Collaboration with UnitedHealthcare is a significant step in that direction and will expand the breadth and depth of Seton Health Alliance services. We are delighted with what it means for Central Texans and local employers.”
“Seton Healthcare Family is a recognized leader in innovative clinical initiatives that improve quality, coordinate care and reduce costs,” said David Milich of UnitedHealthcare. “The approach to care we are launching can help improve care for our 320,000 health plan customers in Central Texas and make the health care system work better for everyone.”
UnitedHealthcare plan participants who currently receive care from Seton Health Alliance care providers do not have to do anything differently to receive ACO benefits, which include enhanced care coordination and follow-up. Primary care physicians in the ACO will receive monthly updates on their patients, enabling them to monitor all of the care each patient is receiving, and to maintain all clinical information about each patient in a secure, single electronic medical record.
Seton Health Alliance care providers will be eligible for payment incentives based on meaningful improvements in measures such as readmission rates, disease management and prevention, patient safety, and care delivery.
The new ACO collaboration will help participating physicians and Seton hospitals improve transitions of care for patients and facilitate better communication with other medical providers involved in a patient’s treatment.
For example, if a patient is being treated for heart disease, all the tests, screenings and medications the patient is receiving will be collected into one record – along with information about any other conditions – to ensure that the appropriate course of care is followed; the care is coordinated among all providers; and the patient is receiving any and all necessary services. This model will help manage services for patients with chronic conditions such as diabetes and heart disease while focusing on preventive health for the entire population.
This is the latest in a series of programs UnitedHealthcare has created to improve the quality and efficiency of health care in line with the Institute for Healthcare Improvement’s “Triple Aim” – increase patient satisfaction, improve people’s health and reduce health care costs.
UnitedHealthcare, which serves more than 3.8 million Texas residents with a care provider network of more than 500 hospitals and 50,000 physicians statewide, is working with thousands of physician groups, hospitals, medical centers and other health care providers nationwide to place greater emphasis on rewarding care providers for better care, better health and lower costs. Today, more than $20 billion of UnitedHealthcare’s annual physician and hospital reimbursements are tied to accountable care programs, centers of excellence and other performance-based programs.
UnitedHealthcare is dedicated to helping people nationwide live healthier lives by simplifying the health care experience, meeting consumer health and wellness needs, and sustaining trusted relationships with care providers. The company offers the full spectrum of health benefit programs for individuals, employers and Medicare and Medicaid beneficiaries, and contracts directly with 780,000 physicians and other health care professionals and 5,900 hospitals and other care facilities nationwide. UnitedHealthcare serves more than 40 million people in health benefits and is one of the businesses of UnitedHealth Group (NYSE: UNH), a diversified Fortune 50 health and well-being company.
Seton Health Alliance (SHA), Central Texas’ first accountable care organization (ACO), is a partnership between Seton Healthcare Family and others to create a clinically integrated network of health care providers. Its goal is to direct medical resources in a way such that health care is delivered efficiently and effectively, with a focus not on the provider, but on the patient.
SHA began as a partnership with Austin Regional Clinic; it now includes Lone Star Circle of Care, Seton Community Health Centers and, as of August 1, 2013, the commercial insurance carrier UnitedHealthcare. In its first year of operation, SHA operated as one of the nation’s 32 Pioneer ACOs, designed to pilot the ACO model with Medicare patients. While still serving the Medicare population, SHA is working to expand its services to reach a large number of Central Texans of all ages.
Seton Healthcare Family is a member of Ascension, the nation’s largest faith-based, non-profit health care system.