Accountable Care Organizations

Catalyst and UnitedHealthcare ACO Has Saved $40 million in Three Years

Coordinated care, data sharing, and reducing out-of-network costs are all part of the collaboration.

Plano-based Catalyst Health Network’s accountable care organization with UnitedHealthcare has increased preventative screenings and reduced healthcare costs in North Texas by $39.8 million between 2016 and 2019, with $10.8 million in savings this year.

The collaboration has also resulted in more efficient referring patterns and the utilization of lower cost care. Fewer out of network laboratory services, specialists, and lower cost ambulatory surgery centers are also part of the savings. Utilizing claims and health data from UnitedHealthcare, Catalyst providers are able to make better decisions about patient care. Physicians are aware of coverage gaps, underlying conditions, and previous treatments that they would not have been aware of without the collaboration. Armed with this data, providers and their care teams can coordinate to provide quality care that doesn’t break the bank.

“The relationship we have with UnitedHealthcare is making a positive impact on our community and the patients we serve,” said Christopher Crow, M.D., president of Catalyst Health Network via release. “We are proud of our results and are committed to achieving better patient outcomes through more efficient, collaborative and innovative care delivery.”

The ACO has also increased the number of employer-sponsored preventative cancer screenings that can lead to early detection, which reduce overall costs for the system and payer. According to release:

  • 5,300 members received breast cancer screenings, compared to 3,400 the previous year, an increase of nearly 56 percent;
  • 9,600 members received colorectal cancer screenings, compared to 6,300 the previous year, an increase of 52 percent; and
  • 12,500 members received cervical cancer screenings, compared to 8,800 the previous year, an increase of 42 percent.

 

In Texas, diabetes costs have reached $26 billion annually with 15 percent of the adult population suffering from the condition. Collaboration between Catalyst and UnitedHealthcare has also improved control over diabetes and reduced the risk of complicating conditions. According to release, the ACO has resulted in:

  • 2,000 members were screened for diabetic retinopathy (a condition that can cause blindness), compared to 1,300 the previous year, an increase of nearly 54 percent;
  • 4,300 members were screened for nephropathy (a serious kidney-related complication of diabetes), compared to 3,000 the previous year, an increase of 43 percent; and
  • 1,500 members had an A1C level less than 8 percent (indicating well-controlled blood sugars), compared to 1,200 the previous year, an increase of 25 percent.

“Our collaboration with Catalyst affirms that when everyone who touches a person’s health works together with a shared vision of a more coordinated care experience, the result is better-quality care at a lower cost,” said Scott Flannery, CEO of UnitedHealthcare of North Texas via release. “Accountable care relationships are one of the ways we can help transform our health care system. We look forward to continuing to work with Catalyst to drive further improvements in health outcomes and lower health care costs for the people of North Texas.”

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