Health Insurance Quotes
UnitedHealthcare's press release announcing its hands-off medical policy
MINNEAPOLIS, Minn., November 9, 1999 — UnitedHealthcare, a subsidiary of UnitedHealth Group (NYSE: UNH), today announced that it is further advancing its philosophies on consumer choice and physician autonomy through an initiative called Care Coordination. Care Coordination obsoletes certain programs associated with traditional medical management, such as pre-authorization for inpatient hospital procedures, and enhances clinical decision-making between the patient and physician.
"Care Coordination is part of our continuing vision to facilitate a better, more positive health care experience for consumers and physicians," said William McGuire, M.D., UnitedHealth Group Chairman and CEO. "After a decade of focused interaction between providers of care and third parties, we believe it is appropriate to expand on the critical needs of patient education and advocacy, physician support and assistance, complex care coordination, availability of specialized resources, and simplification of the health care system. This initiative has evolved over the last six years and will further our commitment to enhancing the health and well-being of people through all stages of their life.
Care Coordination focuses on improving the health of individuals by offering education, accelerated access to care, coordination of complex and fragmented services and measurement of outcomes, and careful monitoring of members who have chronic and complicated medical conditions. Seven core clinical activities are utilized. These are Health Education, Admission Counseling, Inpatient Care Advocacy, Readmission Prevention, Disease Management, Complex Illness Support and Pharmacy Management. Care coordinators work with both the patient and the doctor to facilitate access to needed care and offer new dimensions of health education and disease management.
"Millions of dollars are spent every year on reviewing the treatment decisions made by physicians. Over the last decade we have seen the value to patients and employers of these efforts diminish as runaway health care costs have been slowed and services expanded. The vast majority of reviews support the clinical decision, so it makes sense to focus on other programs and efforts," said Dr. Archelle Georgiou, Chief Medical Officer for UnitedHealthcare. "Based on the many beneficial programs and efforts available today, our desire is to fully direct our resources at keeping patients healthy and from falling through the cracks of the complex health care system. We want to make it easier for every patient to get care — at the right place and at the right time and help physicians improve services to their patients," she said.
Care Coordination helps doctors and patients reach the best decisions together with the support of UnitedHealthcare's extensive knowledge and resources. To accomplish this, UnitedHealthcare is leveraging its database of more than 14 million patients to provide its doctors with data and information that compare the treatments they are recommending for their patients against national treatment norms. The innovative Clinical Profiles program, initiated in 1997, offers physicians personalized reports and reminders for patients who may benefit from these procedures along with information to take action. The company has shown that this program has clearly improved health care interventions and results.
"We seek to add value to the doctor-patient relationship by helping patients navigate through the health care system so that they can follow through on the treatment plan that they have developed with their physician. We provide support and resources that physicians are often not equipped to offer. Furthermore, we can encourage best practices and support sound treatment decisions using the power of UnitedHealthcare's information technology, clinical research capabilities and consumer communication tools," said Georgiou.
The Care Coordination initiative was begun in 1998 and tested in six markets prior to national implementation. Results from these markets indicated that Care Coordination was able to improve the entire health care experience without additional cost to the employer or member.
UnitedHealthcare provides a full spectrum of resources and services to help people achieve improved health and well being. The company designs and operates organized health systems with commercial, Medicare and Medicaid products. Today, UnitedHealthcare and its sister company Uniprise, which focuses on services to large companies with over 5,000 employees, serve over 14.5 million individual consumers as members of its health service systems. On behalf of these individuals, the company arranges access to care with more than 340,000 physicians and 3,500 hospitals across 35 U.S. markets and four international markets.