Optum's full-risk Medicare Advantage patients have better health outcomes than Medicare enrollees

Optum patients who are enrolled in fully accountable Medicare Advantage plans — where Optum takes full financial and clinical responsibility — have better health outcomes than patients enrolled in traditional Medicare, according to UnitedHealthcare CEO Brian Thompson.

"Today value-based care is the centerpiece of our growth strategy and from my vantage point leading UnitedHealthcare, it is by far the greatest opportunity we have to deliver superior outcomes and lower costs," he said during a presentation at UnitedHealth Group's 2023 investor conference on Nov. 29. 

Mr. Thompson's comments come after a December study published in JAMA Network Open that compared claims data from Optum MA patients to claims data from FFS Medicare patients. The claims data was from Jan. 1, 2018, to Dec. 31, 2019, from more than 316,000 beneficiaries across six states. The data was analyzed from Feb. 1 to June 15, 2022.

Compared to traditional Medicare enrolled, MA members had 18% lower odds of inpatient admission, 6% lower inpatient admission rates through the emergency department, 11% fewer ED visits, 14% fewer avoidable ED visits, a 9% lower 30-day inpatient readmission rate, 10% lower odds of admission for stroke or heart attack, and a 44% less chance of hospitalization for COPD or asthma. MA members also had over 31% higher rates of annual wellness visits. 

Optum has more than 4 million patients in fully accountable care arrangements, which is expected to grow to 5 million by the end of 2024. The company now employs or is affiliated with about 90,000 physicians and 40,000 advanced practice clinicians.

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