Building Strong Provider Partnerships through Value-Based Care Programs

UnitedHealthcare Community & State is committed to supporting our provider partners as they work to improve the health of our members. Through extensive development of our value-based programs nationwide, we are improving care quality, reducing costs, and providing incentives that benefit our provider partners.

Managed care organizations (MCOs) in nearly every state are accredited and regularly reviewed by the National Committee on Quality Assurance (NCQA) and overseen by state legislatures and Departments of Health and Human Services. As a result, UnitedHealthcare Community & State is held accountable for up to 69 quality measures each year. These standards ensure that MCOs provide high-value patient care and invest in measures to improve health outcomes.

Through extensive development of our value-based programs nationwide, we are improving care quality, reducing costs, and providing incentives that benefit our provider partners.

To meet these quality measures and support our provider partners as they care for our members, UnitedHealthcare Community & State has developed robust value-based programs across the nation.

Toward the start of developing our Kansas Community Plan (KanCare) value-based program, nearly 50% of our members were served by our top 25 providers, many of which are FQHCs. Since that time, we have looked to strengthen our relationships with all of our providers through collaboration using different methods, including:

In-person collaboration: Our leadership team directly meets with provider leadership to discuss needs, growth goals, strategic initiatives, and new programs and policies for each year. This communication between C-suite leaders helps strengthen relationships, ensures that both parties are aligned on future goals and priorities, and often leads to expanded discussions. 

Rewards programs: When our members schedule and show up for immunizations, wellness appointments, and other essential services, we offer member rewards. These incentives help drive traffic to provider offices, increase the likelihood that members will keep their appointment, and improve health outcomes by closing care gaps.

Utilizing data: We work with providers to identify members who are accessing out-of-network services that could be better served through more integrated care at that provider facility.

Measuring success

We are actively seeking feedback from key leaders at our high-volume provider organizations. This will help gauge how our value-based programs are being received by provider partners. We are also measuring the success of our value-based programs by monitoring growth at the facility, county, and state levels.

Our leadership team directly meets with provider leadership to discuss needs, growth goals, strategic initiatives and new programs and policies for each year.