Individuals & Families Employers Brokers Physicians Health & Wellness
ARTICLE Health Care Quality

The UnitedHealth Premium® program helps you find physicians that meet guidelines for providing quality care.

In today's health care system, medical practices vary widely, often resulting in variations in the quality of care. Poor quality care can lead to higher complication and surgical repeat rates, unnecessary hospitalizations and a higher chance of a wrong diagnosis.


To address the quality difference in health care, UnitedHealthcare® developed the UnitedHealth Premium® designation program. The program recognizes physicians that meet guidelines for providing quality and cost efficient care.


The UnitedHealth Premium physician designation program uses national industry standards to evaluate for quality and local market benchmarks for cost efficiency across 25 specialties, including family practice, internal medicine, pediatrics, cardiology, and orthopaedics.

 

The following designation results are displayed publicly in UnitedHealthcare's physician directories (e.g., myuhc.com) to support informed decision-making by members when making health care choices and by physicians when making referrals.

 

Designation information is as follows:

  • Quality & Cost Efficiency
  • Cost Efficiency & Not Enough Data to Assess Quality
  • Quality & Not Enough Data to Assess Cost Efficiency
  • Quality & Did Not Meet Cost Efficiency
  • Not Enough Data to Assess Quality & Did Not Meet Cost Efficiency
  • Not Enough Data to Assess
  • Not Evaluated
  • Did Not Meet Quality & Cost Efficiency

Innovative Benefit Plan Designs
In addition, employers may offer health benefit programs (e.g., reduced cost-sharing or tiered benefit programs) that provide benefit incentives for members to use UnitedHealth Premium Tier 1 physicians.

 

Members in health plans that offer tiered benefits may pay lower co-pays and co-insurance amounts for services provided by UnitedHealth Premium Tier 1 physicians.

 

UnitedHealth Premium Tier 1 physicians have received one of the following Premium designations:

  • Quality & Cost Efficiency
  • Cost Efficiency & Not Enough Data to Assess Quality

For more information on the UnitedHealth Premium program, visit UnitedHealthPremium.com. For details on the methodology we use to evaluate physicians, click here. If you would like to provide feedback on the program, please send an email to PremiumProgram@uhc.com.