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Transition to OptumRx

Pharmacy Benefit

Transition to OptumRx

Pharmacy Migration Update

As previously communicated, UnitedHealth Group will consolidate and manage its pharmacy benefit programs internally through OptumRx when the contract with Medco Health Solutions, Inc. expires at the end of 2012. We'll continue to work closely with Medco to ensure a smooth transition of members to OptumRx.

We're preparing to begin a staged, orderly migration in early 2013 onto a highly capable and robust delivery platform. More than $200 million in infrastructure enhancements have been made as OptumRx continues to expand capacity and strengthen operations – in key areas such as technology, operations, tools and staffing.

Proven track record

OptumRx has a history of managing smooth transitions for millions of people. In 2007, it migrated more than 4 million Medicare Part D members. In 2009, OptumRx successfully completed the transition of specialty pharmacy benefits across nearly all of UnitedHealthcare businesses, while simultaneously migrating 1 million Medicaid members.

Commitment to service and quality

OptumRx customers and health plan members are highly satisfied, earning it numerous awards and distinctions for client service and quality offerings. Some of these include:

  • 96 percent satisfaction for mail orders
  • 98 percent first-call resolution in the call centers
  • 99.997 percent mail service claim accuracy

In fact, our Independent Net Promoter score, a measurement of customer loyalty, puts OptumRx in a peer group that includes recognized consumer experience winners like Ritz-Carlton, Google and Facebook.1

OptumRx was the first PBM to earn all four URAC Pharmacy Quality Management accreditations. Additionally, OptumRx has received several customer service awards – and its Prescription Solutions Call Center has been recognized by J.D. Power and Associates for providing "An Outstanding Customer Service Experience."2

Overall the message is simple: We are well prepared for this transition.

Staged approach

The transition will occur on a staged basis, starting in 2013. This phased approach will ensure that customers experience no breaks in service, quality or access to the full range of pharmacy benefits and service support they enjoy now. Initial waves will be analyzed and insights applied to promote a superior client and member experience.

Third party validation

We've assembled a cross-functional team of experts within UnitedHealth Group to conduct thorough testing of our systems and processes to ensure a successful transition. Additionally, we are engaging a third party vendor to validate our testing.

A change for the better

Bringing all our pharmacy services in-house will enhance our ability to deliver improved health outcomes and better manage total healthcare costs. Customers and members can expect the same pharmacy benefits and service support they have today. The transition will be made easier because the value-defining aspects of our UnitedHealthcare customers' pharmacy programs have been, and will continue to be, managed within UnitedHealth Group.

As we get closer to the migration, we'll provide more information about the innovative new products and services that will be available after the transition. You can be sure that we'll keep you informed about the migration schedule – well in advance of any changes.

  1. Net Promoter Score is 62.3 based on 348,305 member surveys conducted January 1-July 31, 2011. Definition and methodology
  2. J.D. Power and Associates 2011 Call Center Certification ProgramSM.

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