Primary Care and ER Care Management

The goal of our Primary Care and Emergency Room (ER) Care Management Program is to improve the quality and affordability of primary care, emergent, urgent and chronic care by developing programs, tools and initiatives and working collaboratively with you. We consider primary care to include patient care delivered by internists, family practitioners and pediatricians.  We are also focused on care provided in urgent and emergent care settings, specifically the coordination and communication of this care to the primary care physician.

UnitedHealthcare offers you tools such as evidence-based medicine (EBM) guidelines, electronic registries, disease management programs, and other value-added benefits that allow you to focus on the patient.  We strive to provide full transparency with regard to how we measure and reward quality.  Our focus on partnering with the physician community is evidenced by our ongoing communication with key national societies such as the American College of Physicians (ACP), American Academy of Pediatrics (AAP) and the American Academy of Family Physicians (AAFP), as well as our recent creation of a new Primary Care Scientific Advisory Board. This board meets with our leadership on a regular basis to help us better understand the physicians' needs and to ensure our initiatives can be effective in your practice environment.

To support the Primary Care Management Program quality and efficiency goals, we have a number of initiatives underway including Disease Management Programs focusing on asthma and diabetes. Brief overviews of our programs are provided below:

Patient-Centered Medical Home
UnitedHealthcare, in collaboration with the AAFP, ACP and AAP, has developed an innovative model for value-based, enhanced payment to primary care physicians for delivery of patient-centered care and achievement of quality, economic and satisfaction outcomes.

Asthma Disease Management
The Asthma Disease Management program is designed to help reduce unnecessary hospitalizations and health care costs and improve the health of those individuals who have Asthma.

Diabetes Disease Management
Our Diabetes Disease Management Program is designed to empower individuals to best manage their chronic disease and related conditions, improve adherence to evidence-based medicine treatment plans and medication regimens, reduce unnecessary emergency room visits, hospitalizations and related health care costs, and ultimately improve quality of life.

ER Point of Care Clinical Data Exchange
UnitedHealthcare has begun an ER Point of Care Clinical Data Exchange that provides several hospitals with technology enabling them to quickly obtain and share patient clinical information when UnitedHealthcare members are present in the emergency room.