Optum’s accountable Medicare Advantage plans outperform traditional Medicare, as revealed by CEO Brian Thompson. A JAMA Network Open study showcased remarkable health benefits for Optum’s 4 million patients, set to grow to 5 million by 2024. Compared to traditional Medicare, Optum’s patients experienced fewer hospital admissions, lower readmission rates, and increased wellness visits. This success underscores the significance of value-based care in achieving superior outcomes while reducing healthcare costs.
Optum’s fully accountable Medicare Advantage plans have revolutionized healthcare, surpassing traditional Medicare in delivering exceptional patient outcomes. CEO Brian Thompson’s announcement, supported by a JAMA Network Open study, highlighted the significant advantages of Optum’s proactive approach to healthcare. This proactive model, encompassing over 4 million patients and projected to expand further, showcases reduced hospitalizations and improved preventive care, heralding a transformative era in value-based healthcare.
In a groundbreaking revelation, UnitedHealthcare CEO Brian Thompson underscored the remarkable success of Optum’s fully accountable Medicare Advantage (MA) plans in enhancing patient health outcomes compared to those enrolled in traditional Medicare. Thompson emphasized the pivotal role of value-based care as the linchpin of UnitedHealthcare’s growth strategy during his presentation at the UnitedHealth Group’s 2023 investor conference on November 29.
This affirmation follows a consequential study published in JAMA Network Open in December, scrutinizing claims data of Optum MA patients against that of Fee-for-Service (FFS) Medicare patients. The study encompassed data gathered from January 1, 2018, to December 31, 2019, encompassing over 316,000 beneficiaries across six states. The meticulous analysis of this data was conducted between February 1 and June 15, 2022.
The comparative analysis revealed that MA members exhibited significantly better health indicators when contrasted with traditional Medicare enrollees. Specifically, MA members showcased an array of advantages, including an 18% lower likelihood of inpatient admission, a 6% decrease in inpatient admission rates through the emergency department, an 11% reduction in emergency department visits, a notable 14% decline in avoidable ED visits, a 9% lower 30-day inpatient readmission rate, and a 10% lower probability of admission for stroke or heart attack. Astonishingly, there was a striking 44% reduced probability of hospitalization for Chronic Obstructive Pulmonary Disease (COPD) or asthma among MA members. Additionally, MA members demonstrated over 31% higher rates of annual wellness visits.
The profound impact of Optum’s fully accountable care arrangements is evidenced by its extensive reach, with more than 4 million patients benefiting from these programs. This number is anticipated to surge to 5 million by the culmination of 2024. Emphasizing the commitment to enhancing healthcare, the company is currently associated with approximately 90,000 physicians and 40,000 advanced practice clinicians, bolstering their capacity to provide comprehensive care.
The success story of Optum’s full-risk Medicare Advantage plans can be attributed to their comprehensive approach to patient care. By assuming both financial and clinical responsibility, Optum ensures a holistic and proactive approach to healthcare delivery. The emphasis on value-based care has not only led to enhanced health outcomes but has also contributed to a reduction in healthcare costs, aligning with the overarching goal of delivering superior healthcare at reduced expenses.
Furthermore, the significant reduction in avoidable hospital admissions and readmissions for various critical conditions among MA members underscores the efficacy of Optum’s preventive care initiatives and proactive disease management strategies. This proactive healthcare model not only fosters a healthier population but also mitigates the burden on healthcare resources by reducing unnecessary hospital visits and readmissions.
The pivotal role played by Optum’s MA plans in augmenting patient wellness serves as a beacon for the healthcare industry, advocating for a paradigm shift toward value-based care. As the healthcare landscape continues to evolve, embracing comprehensive accountable care models like Optum’s becomes imperative in not only improving patient outcomes but also in ensuring the sustainability of healthcare systems.
Overall, the evidence from Optum’s accountable Medicare Advantage plans, leading to enhanced patient outcomes and cost reduction, delineates the power of value-based care. Optum’s proactive model, seen in reduced hospital admissions and improved wellness visits, signifies a paradigm shift in healthcare delivery. As Optum’s patient base continues to expand, reaching 5 million by 2024, the imperative of embracing accountable care models becomes paramount. This success story serves as a beacon, emphasizing the pivotal role of value-based care in shaping a healthier, more sustainable future for healthcare.
