UHC Community Plan of North Carolina champions value-based care

June 13, 2025 2 minute read

Value-based care initiative results:

414k care gaps closed in past year

$20M awarded to providers since 2021

In today’s rapidly evolving health care landscape, UnitedHealthcare continues to transform care delivery through innovative value-based care (VBC) programs. These initiatives enhance health outcomes for members while rewarding providers for delivering high-quality, coordinated care.

In the past year, our variety of VBC initiatives have led to the closure of more than 414,000 care gaps—critical indicators of improved health outcomes. These gaps include screenings, vaccinations and chronic condition management.

As a testament to the success of these programs, UHC Community Plan of North Carolina awarded providers over $20 million in value-based payments since 2021. These rewards recognize the performance of health care professionals who deliver quality care that improves member health.

The power of value-based care

Value-based care shifts the focus from volume to value—prioritizing preventive care, chronic disease management, and patient-centered services. UHC Community Plan of North Carolina’s VBC programs are built on this foundation, aligning incentives with outcomes to ensure that members receive the right care at the right time.

By fostering close collaboration with providers, the UHC helps reduce unnecessary hospitalizations, close care gaps, and enhance the overall well-being of its members as measured by tracking of cost and utilization data. These programs emphasize data-driven insights, care coordination, and proactive health management.

“UnitedHealthcare’s provider incentive program has helped us to more efficiently collect data that concretely documents the work we do, while simultaneously allowing us to pair this with our own internal metrics to show how we’re improving the health and overall well-being of our patients,” said Frankin County Health Department director Scott S. LaVigne.

Phycinity Healthcare has participated in UHC’s incentive programs for several years. “It’s a very useful program,” said chief nursing officer Tasha Sorum. “The resources that are offered by the program are used in monthly reviews at the practice to make sure patient goals are being met. It has assisted in making sure that patients are not falling through the cracks. The quarterly meetings between the UnitedHealthcare team and Phycinity are very important to make sure we are getting the newest information and going over what is needed for improvement.”

Two unique value-based care programs

The health plan has instituted two provider incentive programs since North Carolina’s Medicaid Transformation, which launched July 1, 2021. The first program rewards eligible providers for actively engaging UHC Community Plan of North Carolina members in their preventive health care. Since its launch, the program has distributed over $10 million in incentives to more than 760 provider groups.

In 2024, providers closed approximately 65,000 care gaps. The most widely achieved quality measures include well child visits in the first 30 months of life, cervical cancer screenings and chlamydia screenings. These quality measures are prioritized for the impact they have in preventive care to improve the health of our members.

The second program promotes better preventive care outcomes for members by offering incentive payments tied to measures such as blood pressure control and childhood immunizations. This initiative supports the NC Medicaid Managed Care Quality Strategy by closing care gaps, ultimately enhancing the health and well-being of our members. To date, UHC has awarded over $227,000 in incentives to more than 760 provider groups dedicated to driving meaningful health improvements.

Supporting providers, empowering communities

UnitedHealthcare’s approach is rooted in partnership. Through robust support systems, including advanced analytics, care coordination tools, and dedicated clinical resources, providers are empowered to make informed decisions and deliver personalized care.

In 2025, UHC Community Plan of North Carolina is expanding its incentive program to offer new earning opportunities for providers who actively engage members in their care and drive improved health outcomes. These enhanced incentives are designed to support efforts in closing care gaps across pediatric, adult, maternal and women’s health quality measures. Our goal is clear: to create a sustainable health care system that rewards quality, supports providers and improves the lives of the people we serve.