Complex and chronic care

When faced with a complex or chronic condition, employees have access to ongoing support. From condition-focused clinical programs to compassion-driven support, we help make sure they don't have to go it alone.

Clinical and disease management programs

According to the Centers for Disease Control and Prevention (CDC), 6 in 10 adults have a chronic disease and 4 in 10 have 2 or more, driving 90% of the nation's annual health care costs.1 UnitedHealthcare clinical and disease management programs are designed to provide a data-driven, collaborative approach to helping employees manage their conditions and get healthier.

Identify disease-management opportunities earlier

Advanced analytics help to proactively identify and reach out to program-eligible employees sooner.

Engage employees in their care

Program support includes specialized nurse support, educational materials, access to Centers of Excellence, case management for help closing gaps in care and more.

Help increase satisfaction and lower costs

Employee satisfaction with clinical programs ranges from 93 to 100%.2 Disease management programs generate medical savings of $.80 to $14.05 per member per month, depending on the products offered.3

Support for families with special needs

Reaching out to eligible families

Eligible families who have children with special health care needs from birth to age 17 are assigned a family advisor who acts as their single point of contact.

Resolving issues on the family's behalf

Advisors help create custom care plans, facilitate care coordination, streamline prior authorization and claims issues, connect families to community resources and more.

Helping deliver positive results for families

Since its inception in 2017, the program has increased clinical engagement by 50%, reduced claim rework by 18% and reduced appeals by 16%.4

Support for adults with complex needs

Extending the same level of compassionate support to adults with complex care needs, this new initiative is designed to transform the way employees with challenging health conditions experience health care.

Building trust

Focuses on building lasting relationships with employees and their families and working tirelessly with them, their providers and the health plan to support their health care journey.

Optimizing benefits

Works to ensure that benefits are optimized based on the unique needs of employees with complex health conditions.

Connecting care

Helps connect employees to care with a provider in the right setting.

Share with your clients

Read how UnitedHealthcare is working to help reduce the weight of stress and responsibility on your clients.

Employee experience: Supporting those with special needs

Read about how one family's health care journey demanded high-touch support and compassion.

Footnotes

  1. Centers for Disease Control and Prevention. About Chronic Diseases. Available: cdc.gov/chronicdisease/about/index.htm. Accessed Dec. 11, 2020.
  2. Voice of Integrated Consumer Experience Study. UnitedHealth Group book-of-business, 2018.
  3. Results based on 2018 UnitedHealthcare book-of-business savings from our combined Disease Management programs and additional study representing 2 key components of the product enhancement leveraging pilot results of the digital app and cohort study focused on the enhanced value-based ID strat logic.
  4. Pre-post study conducted on families engaged from Jan '19 - Dec '19. Analysis completed in Oct. '20.

Disclaimers

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.

The Centers of Excellence (COE) program providers and medical centers are independent contractors who render care and treatment to health plan members. The COE program does not provide direct health care services or practice medicine, and the COE providers and medical centers are solely responsible for medical judgments and related treatments. The COE program is not liable for any act or omission, including negligence, committed by any independent contracted health care professional or medical center.