Esse Health and UnitedHealthcare Collaborate to Improve Patient Care in Missouri

Esse Health and UnitedHealthcare are collaborating to improve care coordination and enhance health services through a new accountable care relationship that will benefit more than 300,000 Missourians enrolled in UnitedHealthcare’s employer-sponsored health plans.

Esse Health is an independent, physician-owned multispecialty group with more than 100 physicians across 38 offices throughout the greater St. Louis area. Esse Health specialties include internal medicine, family medicine, pediatrics, radiology, gastroenterology, asthma, urology, allergy and immunology, among others.

Effective Jan. 1, 2016, this collaboration will help shift Missouri to a patient-centered health care system that promotes higher quality, lower costs and better health. The enhanced care coordination enables Esse Health physicians to develop a more complete picture of a patient’s overall health. Participating physicians are reimbursed based on patients’ actual health outcomes and for delivering consistent, high-quality care.

“This innovative model of patient-centered care requires a high level of coordination among patients, physicians and the health plan. We are delighted to partner with UnitedHealthcare on this model to make a favorable impact on the patients we serve,” said Mike Castellano, CEO, Esse Health. “Together, we can achieve better health outcomes and improve patient satisfaction, while lowering health care costs.”

UnitedHealthcare’s accountable care programs touch more than 13 million people nationwide, delivered in part through more than 750 total accountable care arrangements as the organization engages in deeper, more collaborative relationships with physicians and hospitals.

UnitedHealthcare will complement Esse Health’s own data by giving them the support needed to manage overall population health, including information that will help the group’s 100-plus physicians take specific actions to improve quality and lower costs. Actionable data can include patient profiles, identifying specific gaps in care, and receiving real-time information about emergency room and inpatient admissions. Patient navigators also may be used to support community-based care coordination, such as helping with transition plans after an individual is discharged from the hospital, scheduling follow-up appointments and closing gaps in care.

“UnitedHealthcare is working even more collaboratively with physicians so we can help enhance the health of our plan participants in meaningful ways,” said Steve Walli, CEO, UnitedHealthcare – Heartland States. “Sharing accountability with care providers – and making sure they have the resources to succeed as they transition to managing population health – will ensure the health care experience remains focused on patients and their individual health care needs.”

As a long-time supporter of value-based care, the accountable care program will further Esse Health’s move away from a fee-for-service compensation model to a value-based approach in which physicians are eligible to receive payment incentives based on patient satisfaction, achieving certain evidence-based measures – such as hospital readmission rates, effectively managing chronic conditions, and prevention – as well as total cost savings.

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 $43 billion. By the end of 2018, UnitedHealthcare expects that figure to reach

$65 billion.

UnitedHealthcare serves more than 1.2 million Missourians with a network of 158 hospitals and more than 24,500 physicians and other care providers statewide.

For more information about UnitedHealthcare’s full spectrum of value-based initiatives, visit www.uhc.com/valuebasedcare.

About Esse Health
Esse Health is a St. Louis-based, independent physician group that strives to improve the overall well-being of its patients through patient education, lifestyle modification and prevention. With 38 locations throughout the St. Louis and Metro East area, Esse Health’s services include asthma, allergy and immunology, family medicine, gastroenterology, internal medicine, nutrition, pediatrics, radiology, and urology. Esse Health’s adult and pediatric primary care offices have been awarded Patient-Centered Medical Home (PCMH) 2011 Level 3 recognition by the National Committee on Quality Assurance. Esse Health also has been recognized by the U.S. Department of Health and Human Services’ Million Hearts Initiative as a 2014 Hypertension Control Champion for its success in helping patients control their high blood pressure. Esse Health is a recognized leader in using technology in health care and physician accountability for both quality and cost-of-care. For more information on Esse Health, visit www.essehealth.com.

About UnitedHealthcare

UnitedHealthcare is dedicated to helping people nationwide live healthier lives by simplifying the health care experience, meeting consumer health and wellness needs, and sustaining trusted relationships with care providers. The company offers the full spectrum of health benefit programs for individuals, employers, military service members, retirees and their families, and Medicare and Medicaid beneficiaries, and contracts directly with more than 850,000 physicians and care professionals, and 6,000 hospitals and other care facilities nationwide. UnitedHealthcare is one of the businesses of UnitedHealth Group (NYSE: UNH), a diversified Fortune 50 health and well-being company. For more information, visit UnitedHealthcare at www.uhc.com or follow @myUHC on Twitter.