Seton ACO enters contract with UnitedHealthcare

Seton Health Alliance entered an accountable care contract with UnitedHealthcare that the organizations said could extend the reach of the Seton ACO to as many as 320,000 Texans covered by the insurer's employer-sponsored plans.

Seton Health Alliance is a partnership of Seton Healthcare Family (an Austin, Texas-based division of Ascension Health) and other providers in Central Texas, including the multi-specialty physician group Austin Regional Clinic. It is among 32 ACOs participating in Medicare's Pioneer model, which is administered by the CMS Innovation Center and began in January 2012.

The relationship with UnitedHealthcare, effective Aug. 1, is its first with a private payer. The alliance members will be eligible for incentive payments if they improve their performance on measures such as readmission rates, disease management and prevention.

UnitedHealthcare and other large insurers, including Cigna Corp., Aetna and many of the Blues plans, are rapidly forging agreements with providers with payment models that tie reimbursement to quality and cost benchmarks.

UnitedHealthcare says the company now ties $20 billion a year in physician and hospital payments to performance-based programs.