Clinical Programs: Condition Management and Care Management

Our Medicare Advantage plans provide a full spectrum of care management programs as part of our standard plan offerings. Clinical programs include inpatient care management, care and condition management, specialty care management (e.g., transplant and end stage renal disease (ESRD) management), behavioral health care management, HouseCalls, and Advanced Illness. Participation by the member is encouraged, but voluntary.

Condition management programs


UnitedHealthcare condition management programs are designed to help members with chronic conditions, such as diabetes, heart failure, and end stage renal disease (ESRD), to be their healthiest. UnitedHealthcare offers education and resources to support optimal health of members who are currently being treated for chronic conditions. Members receive case management and can attend workshops to engage members in managing their condition.

Care management programs

Inpatient Care Management


Nurses review the clinical information that outlines the clinical treatment plan for the member and evaluate appropriateness for admission based on evidence-based medicine and discharge planning needs, including identification of members for post-discharge follow-up and referral to outpatient programs.

Behavioral Health


Led by experienced geriatric psychiatrists and licensed behavioral health clinicians, our program integrates with our medical team to identify, engage and manage members’ behavioral health concerns.

Community Transitions Program


Designed to reduce complications by smoothing the transition from hospital to home, program staff coordinate transitions in care or changes in member health status to avoid potential adverse outcomes and unnecessary readmissions.

High Risk Care Management


Nurses support members who have complex care needs by helping them access care, coordinate services and understand how to better manage their chronic conditions.

Advanced Illness


Provides comprehensive care for members facing life-limiting illness generally defined as the last 12 months of life.

Transplant Resources


Our transplant management program drives positive clinical outcomes by addressing the complex needs of members who are facing transplants.

Post-Acute Transition Program


Uses an individualized, whole-person approach to remove barriers to discharge from post-acute care, such as skilled nursing facilities (SNF) so the member can safely return to the least restrictive setting possible.

Find a Plan

Call Us

Call UnitedHealthcare at FED TFN, TTY 711 (toll-free)


Hours: 8 a.m. – 8 p.m.

7 days a week

Call UnitedHealthcare at MEDSUPP TFN, TTY 711 (toll-free)



7 a.m. to 11 p.m. ET,

Monday – Friday

9 a.m. to 5 p.m. ET, Saturday

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Make an appointment with a licensed insurance agent/producer in your area