UnitedHealth study shows capitation model works to improve value-based care

Principal treatment doctors paid out below global capitation achieve vital quality metrics at higher rates than individuals paid out below regular payment-for-company, according to new analysis by UnitedHealth Group. 

UHG identified quality variations using metrics from the Countrywide Committee for High-quality Assurance’s Healthcare Success Knowledge and Information Established (HEDIS) similar to preventive treatment and serious circumstances.

The study showed patients treated below global capitation as opposed to FFS were being screened at higher rates for breast most cancers (eighty% versus seventy four%) and colorectal most cancers (82% versus seventy four%) shown higher controlled blood sugar ranges (89% versus eighty%) and were being offered far more eye tests (eighty four% versus seventy four%) and obtained higher rates of functional standing evaluation (96% versus 86%) and medication evaluation (97% versus 92%).  

The investigation of far more than 5 million UnitedHealthcare Medicare Edge enrollees and tens of thousands of key treatment health practitioner practices concluded that doctors paid out below capitation are far better positioned to prioritize preventive expert services and treatment management courses, commit far more time participating with patients and use evidence-dependent clinical guidance.

They also avoid unneeded patient interventions and focus on retaining patients out of the medical center, according to the study.


The findings show that capitation gives the right incentives for value-dependent treatment, UHG claimed.

Capitation pays a set amount per thirty day period per patient and is threat-dependent, giving vendors commitment for price savings owing to far better results.

Medicare Edge options are paid out on a capitation foundation, with various insurers, such as UnitedHealthcare, doing quite nicely in the MA market place.

UHG’s Optum gives health and fitness information technological know-how options to vendors looking to transfer from payment-for-company to value-dependent treatment.

THE Greater Trend

Insurance provider UnitedHealthcare functions with far more than 113,000 doctors and one,200 hospitals in some variety of value-dependent relationship, such as far more than one,250 accountable treatment businesses. 

ON THE History

“International capitation rewards patients, doctors and, far more broadly, the health care system,” claimed Dr. Richard Migliori, main professional medical officer, UnitedHealth Group. “Patients profit mainly because their doctors prioritize preventive treatment to keep them wholesome and out of the medical center.”

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