4,000 Healthcare Providers Receive $54M for HEDIS Excellence
By - Physicians are demonstrating their continued dedication to advancing the quality of healthcare and helping Medicare Advantage members receive optimum treatment and are getting paid accordingly for doing so.
UnitedHealthcare recently distributed nearly $2.9 million in bonus payments to over 350 physicians in Texas on behalf of their work focused on improving health outcomes and mending holes in the healthcare system. The 350 care providers won the annual PATH Excellence in Patient Service Awards for achieving the highest adherence levels for essential quality measures related to the care of UnitedHealthcare Medicare Advantage members.
Outside of Texas, 4,000 care providers in total have received the PATH distinction. Over $54 million in bonus payments has been awarded thus far. Many others – including 40 providers in Virginia, 500 in New Jersey, and 60 in Iowa received between $1 million and $2.5 million in bonus payments.
The PATH program criteria is based on the ability to meet or exceed 17 different Healthcare Effectiveness Data and Information Set (HEDIS) measures. Such measures – utilized by both health plans and the Centers for Medicare & Medicaid Services (CMS) – include the percentage of eligible members who receive a breast cancer or colorectal cancer screening and the percentage of those who adhere to diabetes, blood pressure, or cholesterol medications.
Less than 1 in 2 adults over age 65 is up-to-date with tests, screenings, and other core preventative services, says the Centers for Disease Control and Prevention (CDC). This proves to be problematic, especially as a large Baby Boomer population collectively ages.
Making sure an aging population is taking precautionary health measures is key to advancing the healthcare industry and strengthening the health of an older population. As RevCycleIntelligence.com reported, a staggeringly large percentage of Medicare spending goes toward caring for Baby Boomers’ chronic conditions, especially within a home setting.
Twenty-five percent of adults between age 50 and 64 years old are up-to-date on “potentially life-saving” preventative services, says the CDC. “It is true that these services are covered, in part or completely, by most insurance plans, including Medicare and Medicaid,” the CDC confirms.
As EHRIntelligence.com reported, “HEDIS scores are now used by Medicare, the majority of state Medicaid plans, and numerous private insurers to benchmark performance, reward improvement, and pinpoint opportunities for change.” The importance of HEDIS is increasing, as more industry stakeholders implement accountable care initiatives related to various cost and risk sharing goals from the Department of Health and Human Services (HHS), EHRIntelligence.com confirms.
“We are committed to recognizing and rewarding physicians in Texas for consistently helping our plan participants live healthier lives,” says Sam Ho, MD, UnitedHealthcare’s Chief Medical Officer. “As UnitedHealthcare continues building deeper, more collaborative relationships with care providers, the PATH Excellence in Patient Service Awards are just one step we are taking to support the transition to a value-based health care system in which payment is increasingly based on ensuring the people we serve receive the quality care they need,” Ho maintains.
It is hopeful such widespread bonus payments on behalf of UnitedHealthcare will help physicians and healthcare providers enact actionable change that will result in a healthier patient population overall.
