Dr. Thomas Biuso has witnessed some impressive turnarounds during his 11 years at UnitedHealthcare, but none more so than what he has seen from Arizona Care Network, an Accountable Care Organization (ACO) launched on May 1, 2014. ACOs are groups of health care providers, such as doctors and hospitals, who collaborate to give coordinated high-quality care to their patients.
“What they have accomplished is noteworthy for two reasons: Arizona Care Network truly transformed from a transactional fee-for-service way of doing business to one that improves the quality of care for an organization,” said Biuso, senior medical director for UnitedHealthcare, West Region. “And two, it shows how the payer and clinical network can align themselves in a collaborative fashion.”
Arizona Care Network and UnitedHealthcare launched this ACO to help improve care quality and reduce costs for thousands of Phoenix-area residents enrolled in UnitedHealthcare’s employer-sponsored health plans. The collaboration between the two organizations has done just that.
Arizona Care Network includes more than 5,000 clinicians in Maricopa and Pinal counties, as of January 2017. In the second year of the ACO, the care providers within Arizona Care Network reduced health care spending by $3.9 million for UnitedHealthcare members enrolled in employee-sponsored plans by delivering high-quality care and improved outcomes for their patients.
Dr. David Hanekom, CEO of Arizona Care Network, said the improvement in savings is largely the result of both organizations maturing together.
“In my experience it takes 12 months to analyze the utilization, and in 12 to 18 months we start to see the financial savings,” Hanekom said. “The 12-month period is exactly where you should start seeing the impact. As we continue to scale this, we expect to continue to see reduced costs.”
But it’s not only about cost savings. In the first two years of the relationship, the network also reduced acute hospital admissions by 22 percent while reducing acute hospital bed days by 25 percent for UnitedHealthcare members. As a result, fewer members in the Phoenix area are going to the emergency room for care, and UnitedHealthcare members who access care through Arizona Care Network spend less time in the hospital.
Hanekom credits part of the improved numbers to the analysis UnitedHealthcare provides Arizona Care Network, which includes reports on gaps in care that help identify when a patient may have missed an opportunity for getting the care they need and helps physicians close that gap. In addition, UnitedHealthcare provides reports on patients with multiple chronic conditions and monthly claims data.
“UnitedHealthcare produces some of the best reports I’ve seen in my career from any payer and our organization has realized that UnitedHealthcare’s analytics division and its reporting is world-class,” Hanekom said.
Hanekom said the decision by UnitedHealthcare and Arizona Care Network to use information sharing as a strategic tool, rather than as a competitive advantage against each other as provider vs. payer, demonstrated the organizations’ mutual commitment to help improve health care for the people in the surrounding communities.
“The message here is when an organization like UnitedHealthcare decides to share this kind of unique insight with a trusted collaborator like ACN, you can get rapid results. This is the kind of relationship that helps transform our health care system,” he said.
Hanekom said he expects to continue to see improved results as both organizations refine their collaboration to improve quality care and lower costs in the Phoenix area.
“What we do, and what UnitedHealthcare does through our relationship is, we’re recreating a payment, a technology and a policy environment where our physicians can be successful,” Hanekom said.