Loudoun Medical Group enters accountable care program with UnitedHealth

Published March 30, 2016 by Robert Powell, III

Leesburg-based Loudoun Medical Group and UnitedHealth care are collaborating on a program aimed at rewarding physicians based on their patients’ health outcomes.

The accountable-care program is expected to affect 11,000 Virginia residents enrolled in UnitedHealthcare employer-sponsored health plans.

Loudoun Medical Group is one of the largest multispecialty group practices in Virginia. It employs more than 250 care providers in 35 medical and surgical specialties who treat more than 200,000 patients at 112 locations from Berryville to Alexandria.

“We have long partnered with UnitedHealthcare to apply our expertise in health care innovation and patient-centered programs to improve the health of their plan participants and advance toward overall population health management,” Mary Beth Tamasy, the CEO of Loudoun Medical Group, said in a statement. “Together, we can achieve better health outcomes and improve patient satisfaction, while reducing the overall cost of care.”

The goal of the accountable-care program is to create a patient-centered system promoting higher quality care, lower costs and better patient health.

Participating physicians are paid based on patients’ actual health outcomes and for encouraging services that consistently have resulted in high-quality care.

By contrast, traditional payments systems are “fee-for-service” arrangements, which encourages doctors to provide more treatments. Payments are dependent on the quantity rather than the quality of care.

UnitedHealthcare will complement Loudoun Medical’s own health-care data, providing information and technology to help it manage overall population health.

The data being examined can include patient profiles, identifying specific gaps in care and following up on emergency room visits and hospital admissions.

Patient navigators may also be used to help coordinate care, assisting with transition plans after a patient is discharged from the hospital and scheduling follow-up appointments.

Under the accountable-care program, physicians will be eligible for payment incentives based on patient satisfaction, achievement of evidence-based measures — such as hospital readmission rates, management of chronic conditions and preventive screenings — and total cost savings.

UnitedHealthcare has more than 750 accountable care arrangements nationwide. Its total payments to physicians and hospitals tied to value-based arrangements have tripled in the past three years to $45 billion. By the end of 2018, the company expects that figure to reach $65 billion.

UnitedHealthcare serves more than 740,000 Virginia residents with a network of 106 hospitals and more than 15,000 physicians and other care providers statewide.