Building Strong Provider Partnerships in North Carolina through Value-Based Care Programs

    The Opportunity 

UnitedHealthcare is committed to supporting our provider partners as they work to improve the health of our members. Through development of value-based programs focusing on preventive health care, we are closing care gaps, improving quality, reducing costs, and providing incentives that benefit our provider partners. We believe the best solutions come when we work together with providers and contribute to a health care model that rewards performance and makes the health care system easier to navigate for those we serve.  

    The Innovation

Since the launch of Medicaid Transformation on July 1, 2021, UnitedHealthcare Community Plan of North Carolina has instituted two provider partner incentive programs. In 2021, the UnitedHealthcare Community Plan of North Carolina Primary Care Professional Incentive (CP-PCPi) program began. This program offers eligible provider partners the opportunity to earn financial incentives for helping their patients who are Plan members become more engaged in their preventive health care.

CP-PCPi payments for the first six months of the program totaled over $700,000 and were sent to more than 650 providers (based on tax ID numbers) in late March 2022. The top three measures were for successful completion of Child and Adolescent Well-Care Visits, Cervical Cancer Screenings, and Chlamydia Screenings. Final payments are expected to reach almost $1 million for this initial 6-month measurement period.

UnitedHealthcare’s incentive program allowed many providers in the state their first opportunity to participate and receive provider incentive payments, along with being rewarded for improving the health of their patients. “As a collaborating partner with UnitedHealthcare, our patients are experiencing better health outcomes, thus contributing to a healthier community. Working together is the only way forward in managing the care of our vulnerable patient populations. Thank you, UnitedHealthcare for your continued support!” said Michelle Lewis, CEO of Triad Adult and Pediatric Medicine, a Federally Qualified Health Center with five locations in Guilford County.

CP-PCPi payments of $708,195 sent to providers in March 2022

Aggregate final payments expected to reach almost $1 million

In addition to CP-PCPi, we are pleased to announce the implementation of a second provider incentive, the UnitedHealthcare Community Plan Health Equity Program Incentive (CP-HEPi) program. This initiative will reward eligible Advanced Medical Home (AMH) providers for helping reduce health inequities associated with racial and ethnic identities.

CP-HEPi focuses on positive outcomes tied to preventive measures among underserved populations, including controlling high blood pressure, diabetes care, childhood immunizations, and well child visits. CP-HEPi aligns with the NC Medicaid Managed Care Quality Strategy to promote equity through reduction or elimination of health disparities. 

    Next Evolution

Value-based programs help drive clinical collaboration and better align incentives around both cost and quality. We understand positive outcomes rely on coordination with and responsiveness to our provider partners, and we strive to foster collective accountability while keeping lines of communication open and active.

As we continue to develop our value-based program approach, the UnitedHealthcare Community Health Plan of North Carolina remains committed to improving program flexibility, enhancing supporting data and reports, and promoting payment transparency. 

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