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Optum Health Primary Care Practices Outperform Hospital-Based and Other Physician-Owned Practices on Quality and Cost for Medicare Patients

Optum Health primary care practices with employed physicians have clear incentives to keep patients healthy and lower their total costs, helping clinicians deliver preventive services, manage chronic conditions, make referrals to high-quality specialists, avoid unnecessary and costly interventions, and reduce the need for hospitalization.

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  • Less than 7% of Commercial Health Premiums Goes to Administration – with Clinical Access and Support, Technology, and Consumer Engagement Representing Most Administration Costs

    The vast majority of fully insured commercial premiums is dedicated to medical spending, which covers preventive services, scheduled clinical visits, ongoing care for chronic conditions, and unexpected needs.

    Feb. 14, 2025
    Research Brief

  • Optum Health Primary Care Practices Outperform Hospital-Based and Other Physician-Owned Practices on Quality and Cost for Medicare Patients

    As primary care practices seek needed partnerships, Optum Health offers a better alternative than hospital ownership by aligning the interests of patients, physicians and payors.

    Feb. 04, 2025
    Research Brief

  • Increased Use of Home Delivery Pharmacies by Commercially Insured Individuals Can Save Consumers and Employers an Additional $23 Billion on Prescription Drug Costs over 10 Years

    U.S. consumers and employers are already saving an estimated $600 million annually on home delivery of maintenance medications.

    Sept. 26, 2024
    Research Brief

  • Medicare Advantage Costs the Federal Government Less than Medicare FFS and Provides $60 Billion Annually in Additional Value through Lower Out-of-Pocket Costs and Additional Services

    The additional benefits offered in Medicare Advantage – which are not covered by Medicare FFS – are delivered for no additional cost to the federal government and with out-of-pocket savings to the beneficiary.

    June 24, 2024
    Research Brief

  • Surest is Providing High-Quality Health Coverage that is Affordable, Predictable, and Equitable

    UnitedHealthcare’s Surest, a value-based copay plan with a broad provider network, offers predictability to consumers and helps employers incorporate health equity principles into their health benefits.

    April 23, 2024
    Research Brief

  • All 23 Million Uninsured Individuals Are Eligible for an Existing Source of Health Coverage

    Making existing sources of coverage more affordable and accessible can reduce the number of uninsured people in the U.S.

    Feb. 29, 2024
    Research Brief

  • Medicare Beneficiaries Achieve Greater Medication Adherence with Home Delivery 90-Day Prescriptions

    Up to 32% fewer individuals are non-adherent compared to those with retail 90-day prescriptions.

    Jan. 23, 2024
    Research Brief

  • Commercially Insured Individuals Achieve Greater Medication Adherence with Home Delivery 90-Day Prescriptions

    Up to 38% fewer individuals are non-adherent compared to those with retail 90-day prescriptions.

    Jan. 23, 2024
    Research Brief

  • Surest Enrollees Have 54% Lower Out-of-Pocket Costs and 11% Lower Total Medical Costs than Other Commercially Insured Individuals

    UnitedHealthcare’s Surest, a value-based copay plan with a broad provider network, is engaging consumers with clear and actionable information on the effectiveness of different providers and treatment options and the cost of health care services.

    Dec. 11, 2023
    Research Brief

  • Beneficiaries in Medicare Advantage Receive Better Value and Spend 45% Less than Beneficiaries in Medicare FFS

    Compared to Medicare FFS, MA beneficiaries with chronic conditions receive more preventive care and have fewer emergency department visits and hospital admissions.

    Sept. 28, 2023
    National Research Brief State Briefs

  • Medicare Advantage is Addressing Social Determinants of Health at Scale to Improve Health Outcomes and Advance Health Equity

    Helping Medicare beneficiaries address social needs by connecting them to government and community-based programs can improve health outcomes, enrollees’ quality of life, and support effective use of the health care system.

    Sept. 28, 2023
    Research Brief

  • Self-Insured Employer Plans Offer Innovations that Lower Costs and Improve Employees’ Health

    Over 100 million people in the U.S., 65 percent of those with employer coverage, are covered through self-insured plans.

    June 07, 2023
    Research Brief

  • Telehealth Enabled a 13% Increase in Outpatient Behavioral Health Visits among Medicare Advantage Enrollees

    Ensuring access to behavioral health care for older adults and individuals with disabilities is an important priority.

    May 23, 2023
    Research Brief

  • Seniors Receiving In-Home Clinical Visits Realize Improved Outcomes and Receive More Preventive Services

    One way to improve or maintain seniors’ health outcomes over time is to actively engage them through in-home clinical visits that close and prevent gaps in care by assessing health risks, identifying preventive care opportunities, and supporting primary care delivery.

    Sept. 23, 2022
    Research Brief

  • Comprehensive Programming for Families of Children With Special Health Care Needs Improves Experiences While Lowering Costs

    Aug. 01, 2022
    Research Brief Citations & Methodology
    Report Summary

  • Telehealth Enabled a 26% Increase in Outpatient Behavioral Health Visits Among Commercially Insured Individuals

    Aug. 01, 2022
    Research Brief Citations & Methodology
    Report Summary

  • High-Performing Skilled Nursing Facilities Could Prevent 100,000 Medicare Hospital Readmissions per Year and Save $56 Billion over 10 Years

    Skilled nursing facilities (SNFs)—which play the vital role of helping patients recover after surgical procedures and medical conditions requiring hospital care—provided post-acute services to over 2 million Medicare beneficiaries at a cost of over $40 billion in 2019.

    Feb. 21, 2022
    Research Brief Citations & Methodology

  • Managed Care Can Improve Health and Reduce Spending for Medicaid Beneficiaries Who Are Elderly or Living with Disabilities

    Nov. 29, 2021
    Research Brief Citations & Methodology
    Report Summary

  • Shifting Care to Ambulatory Surgery Centers Can Save Patients More Than $680

    Sept. 08, 2021
    Research Brief Citations & Methodology
    Report Summary

  • Medicaid Can Cover 45% More Uninsured People than Public Exchanges for the Same Cost

    Medicaid leverages state-based coverage platforms and proven managed care models to provide high-quality, cost-effective health insurance to 75 million low-income people without other coverage options - an increase of 12 million people since 2013.

    May 01, 2021
    Research Brief Citations & Methodology

  • Medicare Advantage Beneficiaries Receive Better Value and Spend 40% Less

    April 08, 2021
    Research Brief Citations & Methodology
    Report Summary

  • Waving the Medicaid Best Price Rule Could Boost Savings from a Commercial Value-Based Arrangement by $4 Billion

    March 26, 2021
    Research Brief Citations & Methodology
    Report Summary

  • Capping Exclusivity for Biologics Could Save $20 Billion on Drug Spending

    Dec. 15, 2020
    Research Brief Citations & Methodology
    Report Summary

  • Performing Joint Replacements in Ambulatory Surgery Centers Could Help 500,000 People Avoid Overnight Hospital Stays and Save $3 Billion Annually

    Dec. 10, 2020
    Research Brief Citations & Methodology
    Report Summary

  • OptumCare Primary Care Practices Deliver More Value to Patients, Outperforming Hospital-Owned Practices on Quality and Cost

    Dec. 01, 2020
    Research Brief

  • Consumers Can Save More than $300 per Diagnostic Imaging Test

    Nov. 17, 2020
    Research Brief Citations & Methodology
    Report Summary

  • Improving Health Literacy Could Prevent Nearly 1 Million Hospital Visits and Save Over $25 Billion a Year

    October 26, 2020
    Research Brief Citations & Methodology
    Report Summary

  • Global Capitation Payments Result in the Highest-Quality Primary Care for Seniors

    Aug. 12, 2020
    Research Brief Citations & Methodology
    Report Summary

  • 10 Million Children with Limited Access To Primary Care Could Receive Annual Checkups in Urgent Care Centers

    June 24, 2020
    Research Brief Citations & Methodology
    Report Summary

  • The Medicare Program Could Save $11 Billion Over Five Years by Reforming Medicare Part B Drug Payment Policy

    June 01, 2020
    Research Brief Citations & Methodology

  • Lowering Hospital Prices to the National Average Price Could Save the Health Care System $225B

    March 01, 2020
    Research Brief Citations & Methodology

  • Consumers Could Save Nearly $50 Billion a Year with Reduced Price Variation of Health Care Services

    Feb. 01, 2020
    Research Brief Citations & Methodology

  • Pharmacy Benefit Management Can Save Medicaid Drug Programs over $110 Billion

    October 01, 2019
    Research Brief Citations & Methodology
    Report Summary

  • High-Value Physicians Can Save the Medicare Program Over $286 Billion in Health Care Costs

    Sept. 25, 2019
    Research Brief Citations & Methodology
    Report Summary

  • Administering Specialty Drugs Outside Hospitals Can Improve Care and Reduce Costs by $4 Billion Each Year

    Sept. 09, 2019
    Research Brief Citations & Methodology
    Report Summary

  • Hospital Price Increases for Inpatient Services Will Cost Consumers and Employers $250 Billion over the Next Decade

    Aug. 12, 2019
    Research Brief Citations & Methodology
    Report Summary

  • 18 Million Avoidable Hospital Emergency Department Visits Add $32 Billion in Costs to the Health Care System Each Year

    July 22, 2019
    Research Brief Citations & Methodology
    Report Summary

  • What is Driving Increases in Health Care Premiums?

    May 16, 2019
    Research Brief
    Report Summary

  • Out-of-Network Emergency Physicians Increase Health Care Prices for Consumers by $6 Billion Each Year

    March 08, 2019
    Research Brief Citations & Methodology
    Report Summary

  • High-Performing Physicians Can Save Consumers Over $700 Billion in Health Care Costs

    March 05, 2019
    Research Brief Citations & Methodology
    Report Summary

  • Addressing the Nation’s Primary Care Shortage: Advanced Practice Clinicians and Innovative Care Delivery Models

    Sept. 11, 2018
    Research Brief Citations & Methodology
    Report Summary

  • Freestanding Emergency Departments in Ohio

    May 10, 2018
    Research Brief Citations & Methodology
    Report Summary

  • Freestanding Emergency Departments in Colorado

    Dec. 06, 2017
    Research Brief
    Report Summary

  • Freestanding Emergency Departments Treating Common Conditions at Emergency Prices

    Dec. 06, 2017
    Research Brief

  • Advancing Primary Care Delivery: An Update

    March 01, 2017
    Research Brief Citations & Methodology
    Report Summary

  • Successful Medicaid Enrollment Strategies to Cover the Uninsured

    June 30, 2015
    Research Brief
    Report Summary

  • Advancing Primary Care Delivery: Practical, Proven, and Scalable Approaches

    Sept. 30, 2014
    Research Brief
    Report Summary

  • The Growth of Specialty Pharmacy: Current Trends and Future Opportunities

    April 29, 2014
    Research Brief
    Report Summary

  • 100 PERCENT OF OUR FUTURE: Improving the health of America’s children (WP 10)

    Aug. 28, 2013
    Research Brief
    Report Summary

  • Medicare and Medicaid: Savings Opportunities from Health Care Modernization (WP 9)

    Jan. 09, 2013
    Research Brief
    Report Summary

  • FAREWELL TO FEE-FOR-SERVICE? A “Real World” Strategy For Health Care Payment Reform (WP 8)

    Dec. 05, 2012
    Research Brief
    Report Summary

  • Personalized Medicine: Trends and prospects for the new science of genetic testing and molecular diagnostics (WP 7)

    March 12, 2012
    Research Brief
    Report Summary

  • The United States of Diabetes: Challenges and opportunities in the decade ahead (WP 5)

    Nov. 23, 2011
    Research Brief
    Report Summary

  • US Deficit Reduction: The Medicare and Medicaid Modernization Opportunity (WP 4)

    October 15, 2011
    Research Brief
    Report Summary

  • Modernizing Rural Health Care: Coverage, quality and innovation (WP 6)

    July 27, 2011
    Research Brief
    Report Summary