Universal American: A “Healthy Collaboration”

By Gregg A. Masters, MPH; originally posted at ACO Watch

I intended to post updates from Aetna and Cigna next in this series, yet today I received a tweet by Vince Kuraitis, aka @VinceKuraitis, calling attention to Universal American a managed care player I’ve not spent much time on. Yet they present a rather interesting profile and operating footprint some of which I will highlight below. According to their website Universal American (UAM):

...provides health benefits to people with Medicare. We are dedicated to a Healthy Collaboration, working together with healthcare professionals in order to improve the health and well-being of our members.

The JPMorgan Healthcare conference deck is here, and webcast here (you may need to register). Of note is with the recent release of CMS certified ACOs, UAM now operates ’31 ACOs approved for participation in the Shared Savings Program which include more than 2,000 participating physicians covering an estimated 300,000 Original Medicare beneficiaries in 13 states.’ So not only are they a player in Medicare Advantage (the end game for risk bearing ACOs), they have a presence in the gateway market as well. For complete details, click here. Two pieces from their narrative tell the story, 1) the ‘healthcare landscape’: 

And, 2) a proforma ACO funds flow in their 50/50% ‘healthy collaboration’ provider/healthplan partnership benchmarked to actuals driving a bottom-line:

Vince’s two cents on Universal American:

UAM is becoming McACO — the McDonalds of the ACO world. Definitely worth keeping an eye on.