1. Medicaid Collaboration
Independent Physicians Network Physician Meeting August 1, 2018

2. Our vision
Reduce medical costs and medical trend
Improve population health and patient experience
Deliver best quality outcomes
COST
CARE
HEALTH
TRIPLE AIM
Better cost controls
CREATE
networks tailored to each market’s unique needs and competitive cost structure
Better experience
CONNECT
individuals with tools and information to engage them in finding the right providers and the right care
Maximizing new market opportunities to make health care more affordable are foundational to helping our members live healthier lives.
Better health
COLLABORATE
with providers to share data and insights to support consistent, high-quality clinical outcomes
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3. The move to value-based care
Current (traditional) care
ACO (value-based) care
Fee for Service provider payment
Care delivery
Pay for Value and increased risk sharing
Lack of technology and incentives for physicians to proactively coordinate patient care
Care coordination
Physicians empowered by technology, data and access to UnitedHealthcare programs
Data and analytics are not routinely shared
Data and information
Analytics provide a full picture of a member’s health risks, care and enhance efficiency
Costs climb without corresponding health improvements
Costs
New shared focus with care providers to manage health care costs and quality
Complicated health care system confuses and frustrates members
Member experience
ACO providers provide trusted support in navigating the system
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4. The Value-Based Care Spectrum
Fee for Service
Performance-Based
Bundled Payments
Accountable Care Programs
Level of Financial Risk
Degree of Clinical Integration
Pay for volume
Performance-based contracts
Primary Care incentives
Episode-based payments
Accountable Care Organizations
Capitation
Sharing savings and/or risk
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5. The Move to Value-Based Care
How do we advance health care through a new kind of relationship with providers?
2014
2015
2018
$36.8B
$45.6B
$65.5B
$12.1
$2.5
$22.2
$16.5
$5.9
$23.2
$25.6
$33.9
$6.0
Performance-based
Condition-specific/Bundled payments
Accountable care
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6. >1,000 110,000 >1,100 41.0% 6.0% 34% >25% 8-12% 8-10% 14%
Our value-based status today
>1,000
Accountable Care Agreements2
110,000
physicians1
>1,100
hospitals1
Impacting over 16 million
members1
Performance-based3
41.0%
Improvement in Early Elective Deliveries (EED)
6.0%
decrease in both ER Escalations to Inpatient A:E ratio and in Potentially Avoidable Admissions
Bundles & Episodes
34%
reduction in medical cost savings for cancer therapy pilot4
>25%
Orthopedics COE Savings per Bundle 5 (Hip and knee replacements, lumbar, spine and disc procedures)
Accountable Care
8-12%
Medical cost advantage vs. market6
8-10%
increase in preventative cancer screenings
14%
lower ER visits
1 Estimated counts across all lines of business as of December 2017; 2 Includes shared savings, shared risk, full risk, capitation, and medical home contracts across all lines of business as of Dec. 2017; 3 Commercial Hospital PBC programs as of Dec. 2017; 4 Savings provided by UHC Oncology team Dec. 2014; 5 Orthopedics OCE performance, ; Savings provided by UHC Health Care Economics as of Q4 2016
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7. A new level of collaboration to help ACOs be successful
Shared savings and shared risk arrangements
Quality measures incentives
ACO Activation Teams provide local support
Population health risk assessments
Optum Link Electronic Gateway reduces administrative costs
New product designs built on ACO “chassis”
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8. Activation team supports success of each ACO relationship
Local ACO Team coordinates the overall relationship
Day-to-day clinical transformation consultant
who prepares and leads ongoing clinical meetings. Holds weekly calls with the practice to collaborate on process.
ACO
ACCOUNTABLE CARE ORGANIZATION
Health care economics
supports contract negotiation, analytics and ongoing reporting. There are ACO HCE dedicated staff in each region.
Market CMO
is the primary clinical executive for collaboration with the ACO clinical leadership. Includes ongoing engagement with the Practice CMO and Clinical Transformation Consultant.
ACO account manager
coordinates our ACO relationship management and provides roster and member attribution management.
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9. Meaningful reporting and access to analytics experts
Our ACO Activation teams include analytic experts to support the use of:
On-demand/self-service, daily, monthly and quarterly reports
Combined geolocation, claim, and demographic data, visually mapped for better insights into causality and intervention tactics
Ability to quickly identify and parse selected members by diagnosis, ER utilization and other user-defined criteria
Comprehensive overview of a patient’s medical utilization, available prior to, during and after each visit
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