Practice Management Alert

Plus, if you made a claim in the AMA suit against UHC, start looking for your check.

If you contract with United Healthcare, you may soon find your physician's reimbursement tied to quality of care. The largest insurer in the United States (based on sales) is going to roll out "value-based" contracts with providers that will offer financial rewards based on quality of care.

The rewards will be based on things such as low hospital readmission rates and performing recommended screenings for affected patients, according to an article in The Wall Street Journal.

United Healthcare is already altering the provider payment system on a small scale, but plans to cover 50 to 70 percent of its commercially insured members by the year 2015, The Wall Street Journal reported.

According to Bloomberg, "hospitals and doctors will see their costs fall through the program" and UHC will also see significant savings of "as much as twice as much as it would spend on incentive payments for doctors because patients will be healthier."

"This is not just an exercise or a pilot," said Sam Ho, chief clinical officer at UHN, according to The Wall Street Journal article. "It represents a significant change in the architecture of our compensation models for doctors and hospitals."

If you filed a claim during the legal battle between the American Medical Association (AMA) and UHC, you can expect your check by mid-April. 

In early February, a federal judge approved the release of payments in the 2009 settlement against UHC. A total of almost $200 million will be paid out to physicians for 15 years of artificially low payments by UHC for out-of-network health services.

"The truly lasting legacy of this court challenge will continue long after the last physician has received a share of the landmark settlement," said Peter W. Carmel, M.D., president of the AMA, in a statement. "UnitedHealth and other insurers no longer will be able to pull the wool over doctors' and patients' eyes when determining payment rates for out-of-network care."

If you did not file a claim, unfortunately, it is too late to do so. But if you did, you should expect your portion of the settlement by April 15, 2012, according to the AMA Website . If you have questions about the settlement or your payment, you can review the AMA's FAQ about the settlement at www.ama-assn.org/resources/doc/psa/uhg-settlement-faqs.pdf.