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University Hospitals, insurer forge new releationship for patients

University Hospitals, Cleveland (Photo Courtesy University Hospitals)
University Hospitals, Cleveland (Photo Courtesy University Hospitals)

An estimated 20,000 patients are expected to be initially enrolled in the Accountable Care Organization, or ACO.

Rob Falkenberg, chief executive of UnitedHealthcare of Ohio, says the insurer and hospital system will work together to reach out to patients with chronic conditions, like diabetes and heart disease, and coordinate their care. Too often, he says, such patients get lost in a complicated health care system, miss appointments and fail to manage their illnesses.

"The ideal system will be catering to them. So this is a long overdue modernization of what needs to happen in health care," Falkenberg says.

The move is also expected to save money by reducing the number of times patients get really sick or need to go to the doctor and file insurance claims.

"Because we're going to have so much more information being shared in a real time manner because of ourselves and the care providers at University hospital, we will also see a long term reduction - short term and a long term reduction - in the cost to deliver that care, which is good for the overall system and the country," Falkenberg says.

ACOs are encouraged under the Affordable Care Act, which provides extra funding for hospitals and insurers that can track specific patients and help them stay healthy.

University Hospitals now has 170,000 patients enrolled in five ACO agreements, including ones for Cigna and Summa Health's Medicare patients. This is United Healthcare's second ACO agreement in Ohio.