In an effort to enhance the way UnitedHealthcare's clinical team monitors acuity of care delivery, UnitedHealthcare Community Plan of New Mexico created a report to track the history of members' utilization of the Disabled Elderly Waiver.
The report is designed for clinical end-users such as service coordinators and clinical managers, and summarizes the "story" of a member's utilization across a period of care.
It gives clinical end users insight to provide proactive health services to their members. They can better tailor services and interventions to actual service utilization patterns, ensuring that members receive the services they need and are as healthy as possible.
The New Mexico clinical team is conducting a three-month pilot program and measuring its effect on care and quality of life factors with the following goals:
A more effective and user-friendly clinical tracking mechanism
Increased percentage of members receiving appropriate services
Increased quality of care/service plans
Reduced utilization of higher levels of care
Increased length of stay in the community
According to the New Mexico clinical team, this report can be utilized for additional Medicaid waiver populations. There are plans for expected production in October and further expansion starting in January 2013.
Helping to ensure that members are receiving the right services at the right time for their individual needs is an important part of UnitedHealthcare's mission to help people live healthier lives.