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Our Quality Improvement Program

At United Healthcare (UHC), our mission is to help people live healthier lives and make the health system work better for everyone. We serve Medicaid and MinnesotaCare members in Anoka, Carver, Dakota, Hennepin, Ramsey, Scott, Washington and St. Louis Counties. In St. Louis county, we also serve members with SNBC, MSHO, and MSC+. And in Scott County we also serve members with SNBC. United Healthcare is always working to improve the quality of the health care and services our members receive. 

How we identify problems and fix them

  • We use tools like data and surveys to find areas or groups of people that need extra help.
  • We work with providers and members to make sure that our members are getting the care they need when they need it.
  • We share health care learning materials with providers and members.
  • We offer financial rewards to encourage better care.
  • Members with complex needs receive extra support from our case managers.
  • We meet with our members in the community.
  • We partner with local groups that support the communities we serve.

United Healthcare Quality Goals

  • Promote population health management programs and activities
  • Improve the member and provider experience
  • Adhere to accreditation and regulatory requirements
  • Serve diverse populations

Quality Improvement Projects

Family and Children

What are we doing to improve pregnancies?

We want to help members have a healthy pregnancy and healthy baby. Healthy First Steps® is a program offered through your health plan. We will work with you and your provider to help you take healthy steps through pregnancy and after delivery. 

Our program helps pregnant members before and after they have their babies. We help with community resources, medical care, and behavioral health care. We guide you to have a healthy pregnancy, receive a car seat, and offer rewards for visiting the doctor. We help families get the care and support they need when they need it most.

What are some of the challenges to improving pregnancies? 

It can be hard to reach members early in their pregnancy if we do not know they are pregnant. We can’t help members if we don’t have the right address or phone number. We ask our members to contact us and their county when they are pregnant or have an address or phone number change. When we and the county have this information, we can sign them up for our program. This makes sure pregnant members receive all the benefits we offer. 

How can we help your baby to stay healthy? 

After the baby is born, it is important for the mom and baby to see the doctor. We can help with scheduling doctor appointments, answering questions, and arranging transportation. The provider will check things like the baby’s weight, eyes, ears, and heart. As the baby grows older, the well-baby checks will teach parents how to raise a healthy child. This might mean talking about exercise, healthy food, and how to prevent injuries.

How do we know we made a difference? 

The goal of the program is to help our pregnant members and their babies be as healthy as possible. We look at data related to care access, health outcomes of our members, and if members are satisfied. Data is reviewed on an ongoing basis. An evaluation of the program also happens each year. In 2023, the nurse case managers helped 87% of our members with a high-risk pregnancy. They did this by helping them engage in care, removing barriers to care, and supporting improved birth outcomes. 

How do we plan to improve on making a healthy difference?  

We will continue to support our members getting to doctor appointments, access to doulas, food, transportation, car seats, and housing. In 2024, we plan to help educate members on how to have a healthy pregnancy and what resources United Healthcare can offer them.  Our goal is to help members have healthy pregnancies and remove barriers to care.

Seniors and SNBC

 

Why is it important to think about mental and physical health together?

It is important to think about the whole person when helping members. Together, diabetes and mental health can have a big impact on well-being. Studies have shown that people with diabetes are at a higher risk of having mental health challenges like depression and anxiety. Understanding the relationship between diabetes and mental health may lead to better outcomes for members. 

What are we doing to improve the health of those with diabetes and mental health issues?

United Healthcare can help members find community resources, medical care and behavioral health care. We give tips for how to manage your health and offer rewards for visiting the doctor. We help individuals get the care and support they need when they need it most.

What were some of the challenges to improving the health of those with diabetes and mental health issues?

It can be hard to help members get the care they need if they don’t know how to treat their medical conditions. Each member has a care coordinator who can help teach them how to care for their health needs. Many of our members live in places where it may be hard to get to the doctor’s office or clinic. To help, we work with members to set up rides to and from their appointments. Having access to the right care at the right time can reduce emergency room visits, hospitalizations, and even early death.

How do know we are making a healthy difference?

Our goal is for our members to be as healthy as possible. We look at data related to access to care, health outcomes of our members, and member satisfaction. Data is reviewed on an ongoing basis. 

How do we plan to improve on making a healthy difference?

We will continue to support our members by offering benefits such as food, transportation, and a dedicated care coordinator for each member. In 2024, we plan to learn more about our members needs and create resources to better support them. Our goal is to help members be healthy both mentally and physically. 

Quality Programs

The Quality Improvement Program Description provides details about what the health plan will do to make things better for our members. This document explains the steps we will take to review our programs and activities. An update of the program description happens every year. This year:

  • We will reward members for getting care.
  • We are working to reduce members needing to go back to the hospital.
  • We are focusing on health differences. 
  • We will achieve full NCQA Accreditation.
  • We are working to get member feedback.

We reviewed last year’s quality programs and activities to see how well we used our resources to improve our members’ health. We also review the quality and safety of our members’ clinical care. We wanted to know where we did a good job and how we can improve the programs for our members. We used the evaluation to plan for this year. Last year:

  • We made outreach to 93% of our members who were in the hospital for mental health.
  • We offered rewards to our members for prenatal and postnatal visits, immunizations, breast and cervical cancer screenings. 
  • We worked with 87% of our members with high-risk pregnancies.
  • We provided 2,600 meals for members recently leaving the hospital for medical or behavioral health.
  • We provided 16,300 meals for members leaving the hospital after the birth of a baby.
  • We included “bucket” car seats in the car seat benefit for our members.
  • We held 21 dental clinics at a local community center, held a coat give-away, and coordinated a Narcan training for the community. 
  • We assisted in the development of the Fairview Community Health & Wellness Hub.
  • We achieved NCQA Interim Accreditation.

We have a work plan that tracks our health plan goals, monitors quality improvement activities, and plans the services we provide to our members. We track issues and the planned interventions. The plan is reviewed and updated throughout the year. 

Health Equity

At United HealthCare, our mission to help people live healthier lives and to help make the health system work better for everyone. 

Health equity means that everyone has a fair and just opportunity to achieve their full health potential. Some of the things we did at United Healthcare:

  • 95% of our Minnesota staff did training and education on health differences through Health Equity University.
  • Health differences training was offered to all of our providers at no cost.
  • We worked with community organizations to understand how they are experiencing health differences. A few of them:
    • Karen Organization of Minnesota
    • Union Gospel Mission
    • Guiding Star Wakota
    • Hmong Nurses Association
    • Mount Airy Boys and Girls Club
    • Dorothy Day Center
  • Programs to address the health differences in maternal and child health.
    • Healthy First Start
    • Meals for Mom’s from Second Harvest Heartland
    • HealthTalk member newsletter 
  • Promoting access to safe and affordable housing, nutritious food, and transportation. 
  • Focus on making health information easier to understand for our members.

We’ve set goals for ourselves in 2024 to address health differences.

  • We will work toward Health Equity Accreditation.
  • We will continue to expand our Health Equity Strategy.
  • We will look for ways to reduce health differences and put those plans into action.

Accreditation

The UHC Community Plan of Minnesota is accredited by a group called the National Committee for Quality Assurance (NCQA).  NCQA shares information with us on how to improve the quality of health care we provide to members. It is our goal to meet their standards for accreditation. Being accredited means we have made a promise to meet high quality care standards. To learn more about NCQA, visit their website.

NCQA

Contact Us

We want to hear your questions and feedback! Please contact us if you would like to learn more or share ideas for what we can do better. Contact United Healthcare at 1-888-269-5410 / TTY: 711 or use your preferred relay service 8 am to 6 pm local time, Monday - Friday.

UnitedHealthcare Community Plan


Disclaimer information
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Looking for the federal government’s Medicaid website? Look here at Medicaid.gov.

UnitedHealthcare Dual Complete plans

Plans are insured through UnitedHealthcare Insurance Company or one of its affiliated companies, a Medicare Advantage organization with a Medicare contract and a contract with the State Medicaid Program. Enrollment in the plan depends on the plan’s contract renewal with Medicare. This plan is available to anyone who has both Medical Assistance from the State and Medicare. Benefits, features and/or devices vary by plan/area. Limitations, exclusions and/or network restrictions may apply. Benefits, premiums and/or co-payments/co-insurance may change on January 1 of each year.

Premium disclaimer

Dual Special Needs plans have a $0 premium for members with Extra Help (Low Income Subsidy).

Benefit disclaimer

Benefits, features, and/or devices vary by plan/area. Limitations, exclusions and/or network restrictions may apply.

Nurse Hotline disclaimer

This service should not be used for emergency or urgent care needs. In an emergency, call 911 or go to the nearest emergency room. The information provided through this service is for informational purposes only. The nurses cannot diagnose problems or recommend treatment and are not a substitute for your provider's care. Your health information is kept confidential in accordance with the law. The service is not an insurance program and may be discontinued at any time. Nurse Hotline not for use in emergencies, for informational purposes only.

UnitedHealthcare Connected® for MyCare Ohio (Medicare-Medicaid plan)

UnitedHealthcare Connected® for MyCare Ohio (Medicare-Medicaid plan) is a health plan that contracts with both Medicare and Ohio Medicaid to provide benefits of both programs to enrollees. 

UnitedHealthcare Connected® (Medicare-Medicaid plan)

UnitedHealthcare Connected® (Medicare-Medicaid plan) is a health plan that contracts with both Medicare and Texas Medicaid to provide benefits of both programs to enrollees.

UnitedHealthcare Connected® for One Care (Medicare-Medicaid plan)

UnitedHealthcare Connected® for One Care (Medicare-Medicaid plan) is a health plan that contracts with both Medicare and MassHealth (Medicaid) to provide benefits of both programs to enrollees. 

UnitedHealthcare Connected® general benefit disclaimer

This is not a complete list. The benefit information is a brief summary, not a complete description of benefits. For more information contact the plan or read the member handbook. Limitations, copays and restrictions may apply. For more information, call UnitedHealthcare Connected® Member Services or read the UnitedHealthcare Connected® member handbook. 

UnitedHealthcare Senior Care Options (HMO SNP) plan

UnitedHealthcare Senior Care Options (SCO) is a Coordinated Care plan with a Medicare contract and a contract with the Commonwealth of Massachusetts Medicaid program. Enrollment in the plan depends on the plan’s contract renewal with Medicare. This plan is a voluntary program that is available to anyone 65 and older who qualifies for MassHealth Standard and Original Medicare and does not have any other comprehensive health Insurance, except Medicare. If you have MassHealth Standard, but you do not qualify for Original Medicare, you may still be eligible to enroll in our MassHealth Senior Care Option plan and receive all of your MassHealth benefits through our Senior Care Options (SCO) program.

Star ratings disclaimer

Every year, Medicare evaluates plans based on a 5-Star rating system. The 5-Star rating applies to plan year 2024.

Important provider information

The choice is yours

We will provide you with information to help you make informed choices, such as physicians' and health care professionals' credentials. This information, however, is not an endorsement of a particular physician or health care professional's suitability for your needs.

The providers available through this application may not necessarily reflect the full extent of UnitedHealthcare's network of contracted providers. There may be providers or certain specialties that are not included in this application that are part of our network. If you don't find the provider you are searching for, you may contact the provider directly to verify participation status with UnitedHealthcare's network, or contact Customer Care at the toll-free number shown on your UnitedHealthcare ID card. We also recommend that, prior to seeing any physician, including any specialists, you call the physician's office to verify their participation status and availability.

Some network providers may have been added or removed from our network after this directory was updated. We do not guarantee that each provider is still accepting new members.

Out-of-network/non-contracted providers are under no obligation to treat UnitedHealthcare plan members, except in emergency situations. Please call our customer service number or see your Evidence of Coverage for more information, including the cost- sharing that applies to out-of-network services.

American Disabilities Act notice

In accordance with the requirements of the federal Americans with Disabilities Act of 1990 and Section 504 of the Rehabilitation Act of 1973 ("ADA"), UnitedHealthcare Insurance Company provides full and equal access to covered services and does not discriminate against qualified individuals with disabilities on the basis of disability in its services, programs, or activities.

Referrals

Network providers help you and your covered family members get the care needed. Access to specialists may be coordinated by your primary care physician.

Paper directory requests

Paper copies of the network provider directory are available at no cost to members by calling the customer service number on the back of your ID card. Non-members may download and print search results from the online directory.

Inaccurate information

To report incorrect information, email provider_directory_invalid_issues@uhc.com. This email box is for members to report potential inaccuracies for demographic (address, phone, etc.) information in the online or paper directories. Reporting issues via this mail box will result in an outreach to the provider’s office to verify all directory demographic data, which can take approximately 30 days. Individuals can also report potential inaccuracies via phone. UnitedHealthcare Members should call the number on the back of their ID card, and non-UnitedHealthcare members can call 1-888-638-6613 / TTY 711, or use your preferred relay service.

Declaration of disaster or emergency

If you’re affected by a disaster or emergency declaration by the President or a governor, or an announcement of a public health emergency by the Secretary of Health and Human Services, there is certain additional support available to you.

  • Part A, Part B, and supplemental Part C plan benefits are to be provided at specified non-contracted facilities (note that Part A and Part B benefits must be obtained at Medicare certified facilities);
  • Where applicable, requirements for gatekeeper referrals are waived in full;
  • Plan-approved out-of-network cost-sharing to network cost-sharing amounts are temporarily reduced; and
  • The 30-day notification requirement to members is waived, as long as all the changes (such as reduction of cost-sharing and waiving authorization) benefit the member.

If CMS hasn’t provided an end date for the disaster or emergency, plans will resume normal operation 30 days after the initial declaration.