Coming Jan. 1, 2023: Enhancing Tiered Benefit Plans with virtual primary care for Tier 1 in select markets

Tiered Benefit plans are designed to help employers and employees save on costs by encouraging employees to receive care from high-value Tier 1 providers. These plan designs help employees select primary care providers (PCPs) identified for delivering the highest value, decrease costs and choose where to get care.

Beginning Jan. 1, 2023, the Optum national provider group of virtual primary care providers will be added to the Tier 1 benefit level for open access plans with PCP tiering. So, in 2023, Tier 1 will consist of physicians who meet criteria for providing quality and cost-efficient care, as well as virtual primary care access from Optum Virtual Care providers.

Benefits of virtual primary care

Virtual primary care is designed to help make it easier and more convenient for employees to establish an ongoing relationship with a PCP — and that relationship is an important one.

Adults without a PCP are significantly less likely to fill prescriptions or get regular preventive screenings, which may impact their health.1 With a virtual PCP quarterbacking all aspects of their health, employees are more likely to get the right care at the right time. In fact, adult members with a PCP are 19% more likely to get recommended preventive screenings than those without a PCP.2

UnitedHealthcare is focused on expanding virtual health offerings. Enhancing Tiered Benefit plans with the addition of virtual primary care may help increase access to quality care, enable simplified engagement and offer opportunities to make care more affordable.

For more information, please contact your broker or UnitedHealthcare representative.

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