Approximately 18,000 UHC-Community Plan (UHC-C) members are attributed to Equality Health Network (EHN) primary care providers (PCPs). The PCPs will continue to receive payment based on their existing UHC-C agreements. EHN and UHC-C have an accountable care model agreement that tracks quality measures and per member, per month expenses. When savings and quality measurement targets are met, there is an opportunity for EHN to share in those savings using its own proprietary system.
Equality Health founder and CEO Hugh Lytle,
At Equality Health, we are building new cultural care pathways to create better outcomes, increase patient adherence and lower the cost of care for underserved communities. Our relationship with UnitedHealthcare will improve access to care for more diverse patients in our community, reduce disparities in health outcomes and improve people’s health and well-being.
Joseph Gaudio, CEO, UnitedHealthcare Community Plan said,
UnitedHealthcare and Equality Health are committed to ensuring people who live in underserved communities have access to the quality, culturally competent care they need and deserve. By collaborating with Equality Health, we can create a more connected health care experience, help improve patient care and enhance people’s ability to live healthier lives.
Two sets of members are included in the agreement. The first is a special program for AHCCCS members enrolled in The Arizona Long Term Care System (ALTCS). The ALTCS group of 57 patients currently live at home and receive Home and Community-based services (HCBS) or reside in an assisted living facility or skilled nursing facility. Specific quality measures measure readmission, IP and ER utilization, and diabetic care.
The larger group of UHC-C AHCCCS members includes members from the Division of Developmental Disabilities, dual complete special needs Medicare Advantage plan, or regular AHCCCS acute care coverage.
EHN expects to create savings and deliver quality care by focusing on:
- Cultural awareness,
- Behavioral health screening
- Use of a comprehensive Health Risk Assessment tool that includes social determinants of health
- Integrated technology
Using a team-based, holistic approach to patient care, Equality Health’s integrated network of physical, behavioral and community-based care providers is designed to deliver quality, culturally effective and coordinated healthcare to patients. The goal of the collaboration with UHC is to improve the identification and collection of social and cultural factors that put patients at high risk, thus reducing avoidable emergency room visits and readmissions to the hospital. A broader HRA assessment also provides much needed patient intel providers can use to manage patients’ chronic health conditions and improve their medication adherence.