Care management and clinical programs

Employees who manage a complex or chronic condition can find it harder to get healthier. UnitedHealthcare's care management and clinical programs are built to help make their decision-making easier and their path to a healthier life smoother — potentially resulting in lower medical costs for everyone.

Care management programs: Broad support for employees

Using data and analytics to identify at-risk employees and opportunities for better whole-person health across multiple conditions, our care management programs are designed to provide diverse health support, including proactive outreach, nurses and case managers.

Standard Care Coordination for fully insured clients

Standard Care Coordination monitors and addresses 50+ conditions across an employee population for potential gaps in care. For employees identified as at risk, resources include:

  • Nurse team to answer questions and offer guidance
  • Admission counselors to help with hospital length-of-stay and discharge planning
  • Access to condition-specific programs and more

Personal Health Support for self-funded clients

Personal Health Support screens up to 100% of an employer's population for 100+ acute and chronic conditions. Personalized support for at-risk members includes:

  • Earlier identification of opportunities for better health
  • Digital tools to help monitor employee conditions and progress
  • Access to an enhanced clinical team and condition-specific programs

Clinical programs: Focused support for specific conditions

Condition-specific clinical programs are designed for clients whose populations may benefit from more specific condition management resources like cancer, kidney, congenital heart disease and more.

Inspiring healthier, delivering savings and satisfaction

93% to 100% satisfaction with clinical programs1

In addition to high employee satisfaction rates, disease-specific clinical programs have generated medical cost savings of $2.68 per member per month.2

Lower medical costs with care management

Clients with Personal Health Support see per member per month savings of $1.80 to $14.05 on medical costs depending on products offered.3

Data-driven health intelligence

Care management programs identify gaps in care for dozens of employee conditions using data from medical claims, lab results, pharmacy, biometric screenings, health assessments and more.

93% active engagement in condition-specific programs4

Programs like Diabetes Disease Management deliver higher engagement rates among enrollees, as well as an ROI of 3:1.5

Compassionate, personalized support for employees

Chronic conditions and complex care needs demand exceptional employee support throughout one's health journey. Support programs for children and adults with complex care needs provide a single point of contact for all aspects of the health care system to help find specialty providers, maximize benefits, resolve unique insurance issues and more.

Footnotes

  1. Voice of Integrated Consumer Experience Study, UnitedHealth Group book-of-business, 2018.
  2. Results based on 2018 UnitedHealthcare book-of-business savings from our combined disease management programs.
  3. Medical cost savings base configuration comparison. Average savings across UnitedHealthcare book-of-business. Actual results will vary, 2019.
  4. National Accounts book-of-business, 2017.
  5. Results based on 2017 UnitedHealthcare book-of-business savings from our combined Disease Management programs and additional studies representing 2 key components of the product enhancement, leveraging pilot results of the digital app and a cohort study focused on the enhanced value-based identification and stratification logic.

Disclaimer

Disease Management programs and services may vary on a location-by-location basis and are subject to change with written notice. UnitedHealthcare does not guarantee availability of programs in all service areas and provider participation may vary. Certain items may be excluded from coverage and other requirements or restrictions may apply. If you select a new provider or are assigned to a provider who does not participate in the Disease Management program, your participation in the program will be terminated. Self-Funded or Self-Insured Plans (ASO) covered persons may have an additional premium cost. Please check with your employer.