UnitedHealth CMOs target lower-cost sites of service, care gaps

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Richard Migliori, MD, executive vice president of medical affairs and chief medical officer at UnitedHealth Group, and Margaret-Mary Wilson MD, executive vice president and associate chief medical officer at UnitedHealth, outlined several long-term care strategies during a June 16 call.

Three takeaways:

1. Gaps in care

UnitedHealth aims to close 600 million gaps in care by 2025. Dr. Wilson said UnitedHealth defines a gap in care as a moment when patient care falls short of clinical standards, such as a missed cancer screening.

The company plans to close gaps through multiple initiatives, including Optum's HouseCalls program — which connects patients in their home with primary care and virtual care services — and EHR-connected point of care assist tools.

2. Site of service 

UnitedHealth plans to move more than 55 percent of members' outpatient surgeries and radiology services from hospital-based sites to lower-cost ones by 2030. The CMOs said if more joint replacement surgeries were performed in ambulatory surgery centers, it could save the U.S. health system $3 billion annually and lead to 500,000 fewer hospitalizations.

3. Telehealth

Of the 57,000 physicians in OptumCare, only about 150 were using telemedicine before the pandemic, Dr. Migliori said. After the pandemic hit, more than 17,000 physicians got qualified to treat patients through virtual visits. OptumCare providers went from treating about 50,000 telehealth cases a year to more than 2 million in this first quarter alone, Dr. Migliori said.

Telehealth use has since fallen. While at one point 40 percent of visits were completed through telemedicine, that percentage has dropped to about 15 percent and seems to be holding, Dr. Migliori said. In behavioral health, though, 60 percent of visits are being done virtually.

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