Helping patients with complex needs navigate the health care system

Those with complex health needs require care that’s adaptive to their unique situation — catered to the whole person, not just the disease.

Rare, genetic diseases affect an estimated 25 to 30 million Americans, and may include everything from cystic fibrosis, muscular dystrophies and inherited types of cancer. 

Studies show those with complex care needs are likely to:

  • generate five times more medical claims
  • have hospital stays that are 10 times longer
  • visit out-of-network providers 11 times more

“Patients who struggle with complex health conditions and navigating the health care system require personalized care that is adaptable to their unique needs. This includes a tailored approach for optimized care coordination and most importantly, compassion and support,” said Rebecca Madsen, chief consumer officer for UnitedHealthcare.

Complex Care Concierge, a new service offered by UnitedHealthcare, matches eligible members and their families with a dedicated care advocate who helps provide personalized support – focused on finding effective and efficient care that anticipates their needs and works to find solutions.

Complex Care Concierge may benefit patients and their families by:

  • Optimizing benefits. Using advanced technology to continuously monitor coverage and care in order to anticipate potential issues.
  • Connecting care. Helping members and their families gain access to a comprehensive network of health care providers and facilities to meet their needs, as well as collaborating with health systems across the network to support ongoing care and treatment.
  • Supporting social services. Through a comprehensive focus on social, emotional and environmental conditions, known as social determinants of health, advisors help address barriers that may prevent patients and their families from accessing care and connects them to community resources.
  • Connecting relationships. A support team and one-on-one relationship with a care advisor who serves as a source of expertise to help connect patients to quality care. They work tirelessly for members and their families throughout their health journey.

“By offering a more in-depth coordinated system of support, Complex Care Concierge aims to improve a person’s health outcomes and the health care experience for both the patient and their family,” Rebecca said.

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