LCMC Health System is participating in UnitedHealthcare’s NexusACO™ health plan, a health benefits option that offers plan participants high-performing care providers who have proven results for delivering quality and efficient care, resulting in lower costs and better health outcomes.
The NexusACO plan will be available to employers in Louisiana with fully-insured and self-funded UnitedHealthcare benefit plans during this fall’s open-enrollment period, with coverage beginning Jan. 1, 2019.
NexusACO includes a network of physicians and facilities, including LCMC Health, associated with local “Total Cost of Care” initiatives. These include organized groups of physicians, hospitals, and other care providers working together to coordinate patient care and participating in incentive programs to improve quality standards and more efficient care.
UnitedHealthcare’s NexusACO will offer lower premiums and cost for employers, while giving employees access to high-quality LCMC Health providers who will improve the coordination of their care and lower out-of-pocket costs. UnitedHealthcare’s collaboration with LCMC Health includes sharing timely information about emergency room visits, hospital admissions, and other care received outside the doctor’s office.
NexusACO delivers value to consumers and employers through three key features:
Better care coordination. NexusACO plan participants will partner with an LCMC Health primary care physician (PCP), a trusted medical resource who helps patients navigate the health care system, including specialists, hospitals, and other care providers. These physicians can identify care opportunities that might otherwise be missed.
Promotes better health outcomes. NexusACO provides access to care providers who proactively engage their patients more frequently, ensuring at-risk patients receive timely, appropriate health screenings, and helping people manage chronic diseases such as diabetes, heart disease, and arthritis.
Lower costs for high-quality health care. Employers who choose NexusACO may achieve savings on overall healthcare costs. These savings come from the plan’s emphasis on encouraging employees to use in-network Tier 1 care providers to coordinate their care.
“Louisiana employers want their employees to be able to choose high-performing physicians who have a proven track record of improving patients’ health,” said Joe Ochipinti, CEO of UnitedHealthcare-Gulf States Region. “NexusACO addresses this need while simplifying coordinated care. We welcome the opportunity to work with LCMC Health to offer plan participants a more satisfying overall experience at a great value.”
“By participating in UnitedHealthcare’s NexusACO, LCMC Health physicians and care teams can provide better health results for more people in our community,” said Gregory Feirn, CEO of LCMC Health. “We’re committed to coordinating patient care to identify health conditions early, providing timely care for chronic diseases and promoting healthy lifestyles, and avoiding duplicative or unnecessary tests.”
More than 15 million people enrolled in UnitedHealthcare plans across the country have access to a spectrum of accountable care programs, delivered in part through more than 1,000 accountable care arrangements nationwide as the organization engages in deeper, more collaborative relationships with physicians and hospitals.
Care providers nationwide are showing strong interest in a shift to value-based care. UnitedHealthcare’s total payments to physicians and hospitals that are tied to value-based arrangements have tripled in the last three years to more than $64 billion. By the end of 2020, UnitedHealthcare expects that figure to reach $75 billion.