UnitedHealth Brief: High Value Physicians Can Save Medicare $286 Billion

If all the U.S. physicians who treat Medicare Fee-For-Service patients were to meet quality and cost-efficiency criteria, Medicare would save $286.8 billion between 2020 and 2029, according to a new UnitedHealth brief. The savings in 2020 would be $20.5 billion for Medicare fee-for-service.

Meeting these criteria would create “high value” physicians, whose per-episode cost of care is 6.9 percent lower than other physicians according to the brief. These physicians also experience 21 percent lower risk-adjusted spending relative to other physicians, with 64 percent fewer inpatient hospital days and 35 percent fewer emergency department visits.

If primary care physicians meet quality and efficiency requirements, savings for Medicare could be $14.5 billion in 2020, and $202.9 billion between 2020 and 2029. Primary care sees nearly 60 percent of patient volume of medicare patients, the report says.

The report analyzed a number of specialists and operations, and found that high value physicians have better outcomes. The evidence-based approaches used by orthopedic surgeons reduced complications by 10 percent in the average knee replacement, with 14 percent fewer revisions. In cardiology, nephrology, and neurology, per-patient per-episode  savings were greater than 10 percent for high value physicians. Higher quality and lower costs were also found in primary care, pulmonology, and general surgery.