UnitedHealth updates 'next-generation health system' plan: 3 things to know


UnitedHealth Group further outlined its stances on creating the "next-generation health system," which includes attaining universal health insurance coverage, healthcare affordability and improving outcomes. 

UnitedHealth first published its ideas about what the healthcare system of the future should look like this summer.

Three things to know

1. UnitedHealth said 28 million Americans could gain insurance by expanding Medicaid in states that haven't yet, and also expanding ACA marketplace programs. The insurer suggested that eligible Americans should be passively enrolled in Medicaid and subsidized health plans in the ACA exchanges with the ability to opt out. UnitedHealth also said "empowering states to offer public and private coverage platforms will increase choice and competition and result in higher coverage levels."

2. The insurer said the industry could see a 30 percent reduction in unnecessary medical expenses if a single, national set of care measures were used to guide clinical practices. UnitedHealth also said that if commercial and government payers had to provide members with digital access to cost and quality information, members would be 10 percent more likely to choose a higher-performing provider.

3. One way to improve healthcare affordability is to end surprise billing practices, UnitedHealth said. The insurer suggested implementing a median in-network rate for out-of-network provider services. UnitedHealth estimated doing so would reduce annual premiums by $250 per person, or $40 billion annually.  

"A median benchmark represents the prices that hospitals and physicians have agreed to in private-sector negotiations between them and plans. Legislation is merely saying out-of-network providers should accept the reasonable rates that their peers are already accepting," according to UnitedHealth.

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