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N.J. providers earn $2.5M in bonuses from UnitedHealthcare

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Nearly 500 New Jersey doctors have received a total of about $2.5 million in bonuses from UnitedHealthcare for excellence in treating its Medicare Advantage members, the insurer announced Monday.

The Garden State doctors were among nearly 4,000 care providers nationwide who earned more than $54 million in bonus payments as winners of the PATH Excellence in Patient Service Awards for improving health outcomes and closing gaps in care, UnitedHealthcare said in a news release.

“We are committed to recognizing and rewarding physicians in New Jersey for consistently helping our plan participants live healthier lives,” Dr. Sam Ho, UnitedHealthcare’s chief medical officer, said in a prepared statement.

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UnitedHealthcare — which is based in Minnesota and has its primary New Jersey offices in Iselin — said the PATH program rewards doctors who meet performance-based criteria, such as reaching goals in 17 specific health care effectiveness measures, when treating Medicare patients.

The program has four main components, UnitedHealthcare said:

  • Patient support and communication, including mailings, emails and phone calls;
  • Actionable patient data and reporting, such as provider reports with detailed statistics;
  • Financial compensation for doctors, which include the bonus payments;
  • Practice-based support, in the form of tools and customized support.

The awards are part of a nationwide shift toward performance-based evaluation of health care, including preventative health care services and proactive treatment of chronic conditions, rather than the traditional fee-for-service model.

“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 said.

The insurer said its total payments to doctors and hospitals that use a value-based arrangement have nearly tripled in the past three years, to $38 billion. It predicts that, over the next three years, those payments will rise even further, to $65 billion.

Doctors in UnitedHealthcare’s PATH program are treating nearly 1 million Medicare Advantage members in 2015, the insurer said. UnitedHealthcare said it treats nearly one in five Medicare beneficiaries.

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