In a recent webcast, Steve Cain, CEO of UnitedHealthcare of California, and Myoung Cha, Chief Strategy Officer of Carbon Health, announced that the insurer will begin an at-risk primary care arrangement for the state’s commercial PPO market in partnership with Carbon Health, starting in January 2024. The deal represents Carbon Health’s first at-risk arrangement. Under the contract, Carbon Health will be accountable for the total cost of care for UnitedHealthcare’s PPO-covered lives in the state over the next several years. By delivering high-quality care and prioritizing preventive care, Carbon Health will look to reduce overall spending while improving patient health. As in typical risk-bearing contracts, the provider will share in the savings.
Here’s what’s interesting: “The alliance is a novel development because it’s one of the first urgent care models to embrace risk as a primary care provider—and they’re doing so in the commercial space,” says Alan Ayers, MBA, MAcc, president of Experity Networks and Practice Management Editor of JUCM. Risk-bearing models have gained traction, especially in Medicare Advantage markets, and many legislators believe the models are the only way to get control of runaway spending.