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UnitedHealth Group to offer national ACO in at least 15 U.S. markets in 2017

by Gail Kalinoski, Contributing Reporter | November 03, 2016
Business Affairs
UnitedHealth Group will be launching NEXUS ACO next year across the United States through its insurance business, UnitedHealthcare, in the latest attempt to improve care and lower expenses.

The nationally branded accountable care organization will be available to participants in 15 markets: Richmond, Va.; Phoenix and Tucson in Arizona; Los Angeles, Orange County and the San Francisco Bay area in California; Denver; Chicago; Northern New Jersey; Cleveland and Columbus in Ohio; Rhode Island; and Austin, Houston and San Antonio in Texas, according to a report by Forbes.

It will be offered to self-funded employers with 100 or more workers during this fall’s enrollment period. Forbes stated that a dozen employers have already signed on but noted UnitedHealth would not disclose any names yet.

ACOs are groups of doctors, hospitals and other health care providers who contract together with health insurers to improve care and lower costs for their Medicare patients. The goal is to share in the savings if it succeeds in delivering high-quality care at lower prices but if they can’t both improve care and lower expenses, they won’t get the shared savings, according to Forbes.

The NexusACO is a national network of physicians that are supposed to be meeting those marks, and the hope is that they will guide their enrollees to have better health outcomes and lower costs. It is different from regional ACOs, which usually have only local providers, and contracts with providers only in those regional markets.

“This (ACO) will have a much more national view with consistency across how the product is designed,” Jeff Alter, UnitedHealthcare’s CEO of employer and individual coverage, told Forbes in an interview. “It’s sold as a product that happens to have a unique network attached to it.”

The ACOs, which came about as part of the Affordable Care Act, are growing in popularity. UnitedHealthcare has contracts with more than 800 ACOs throughout the United States, according to Forbes. Other insurers are also increasing ACO contracts. Aetna, for example, announced a co-branded, commercial, product-based ACO agreement earlier this year through Meridian Health Partners in Monmouth and Ocean counties in New Jersey. Known as Aetna Whole Health(SM), it became available in July for self-insured businesses and fully-insured customers.

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