Helping you coordinate patient care
UnitedHealthcare members may receive services from more than one health care professional or undergo transitions in health care settings. Care coordination among all health care professionals involved in a member’s care can help improve health outcomes and overall experience.
Point of Care Assist
One way to coordinate care for UnitedHealthcare members is by using Point of Care Assist®, which adds real-time patient information — including clinical, pharmacy, labs, prior authorization and cost transparency — to your existing electronic medical records (EMRs) to make it easier for you to understand what patients need at the point of care.
In addition to Point of Care Assist, we offer several care coordination programs detailed in the 2023 UnitedHealthcare Care Provider Administrative Guide > Chapter 13: Health and disease management. Examples of our care coordination programs include:
Controlled substance monitoring
This program helps providers identify members who may benefit from prescription pain management regimens. Through this program, providers receive a comprehensive member-specific report that includes:
- The clinical issue of concern
- Prescription utilization details
- Recommended action(s)
Providers are encouraged to contact identified members to discuss and re-evaluate their overall pain management regimens and coordinate appropriate treatment, if indicated.
Timely postpartum care and maternity support
Timely postpartum care can help contribute to healthier outcomes for women after delivery. We use HEDIS® guidelines to measure postpartum visit compliance. The standard is a postpartum visit between 7 and 84 days after delivery. Members can access maternity support resources on myuhc.com.
Kidney disease program
This program is designed to help improve clinical outcomes for members with end-stage renal disease (ESRD). The program coordinates care among the member’s care providers to help manage comorbid conditions, as well as dialysis therapy. Goals include reducing inpatient hospitalizations, emergency room visits, transplant education and recommendations, and mortality, while improving quality of life.
Diabetic eye exam
Regular eye exam screenings for members with diabetes may help detect diabetic retinal disease. We use HEDIS guidelines to measure retinal eye exam performance for members ages 18-75 who have type 1 or type 2 diabetes. Continuity and coordination of care may be monitored through communication between the member’s primary care physician (PCP) and the eye care professional performing the dilated retinal exam.
Coordination of care survey questions
We ask members and health care professionals to provide their feedback on coordination of care through regular surveys. These surveys give us valuable information about their experience so we can continue to improve our care coordination programs.
Transitions of care
Follow-up visits after a member is discharged from the hospital should be timely, especially for members with complex care and after-care needs who are at risk for relapse and rehospitalization. This includes members with behavioral health or substance use disorders.
Questions?
Availability of these care coordination activities vary by health care plan. Contact us for more information.
