UnitedHealthcare Overview Brochure

Your guide toUnitedHealthcare

Face the future with confidenceThe benefits environment remains challenging. Uncertainty reigns as a wave of new regulationsweeps across the industry. Costs continue to rise while employers and the nation’s health caresystem creak under an increasing burden of chronic diseases like obesity and diabetes.

Now more than ever, you need a benefits company with deep expertise and innovativesolutions for successful long-range health benefits planning. Now more than ever the rightchoice is UnitedHealthcare.

Changing the system, one person at a timePeople who are actively engaged in managing their own health are more likely to make goodhealth decisions and achieve better health outcomes.1 UnitedHealthcare can help youremployees get actively involved: providing the tools and resources to help them live healthierlives. That may mean reduced absenteeism, better productivity and lower costs for your firm.

Individually, we can each change our behaviors to help improve our own health. Collectively,we can help modernize the health care system and make quality care affordable andsustainable for all Americans. UnitedHealthcare is ready to play a key role in driving thisessential transformation.

1How Engaged Are Consumers in Their Health and Health Care, and Why Does It MatterResearch Brief No. 8, October 2008, Center for Studying Health System Change; www.hschange.com/CONTENT/1019/

Your Guide to UnitedHealthcare � 1

A legacy of innovationWe’re a different kind of health care company.We consistentlyapply creative, innovative solutions focused on helping peoplelive healthier lives and creating superior value for you.

Our record of innovation stretches back over two decades.We’ve worked to develop new approaches designed to improvehealth and well-being. In many ways we’ve helped transformthe health care system through technology and researchinvestments that generate creative, next generation solutions.But always we’ve maintained our commitment to simplify thehealth care experience.

2Fortune magazine; March 22, 2010

Fortune magazine ranked

UnitedHealth Group

#1 for innovation in the

health insurance and

managed care sector.2

1992

1998

1999

2000

2008

2009

2010

First company to produce a report card on health care access,quality, and cost measures.

The first release of Clinical ProfilesSM takes place. Clinical Profilesprovides network physicians with data comparing their clinicalpractices to nationally accepted benchmarks for care.

Care Coordination provides integrated case management forchronic or complex conditions by channeling resources to closegaps in care for those who can benefit most.

First evidence-based 3-tier pharmacy plan that assignsmedications to a tier based on its overall impact on total healthcare costs, not just by generic versus brand name.

The company is the first to adopt National Comprehensive CancerNetwork standards for determining chemotherapy drug coverageas part of its commitment to best science.

First national telehealth network; remote video technologysystems that give patients access to physicians and specialists.

Groundbreaking Diabetes Prevention and Control Alliancecollaborating with the YMCA and Walgreens to help prevent andcontrol diabetes, pre-diabetes and obesity.

2 � Your Guide to UnitedHealthcare

Putting innovation to workThere is a consistent thread running through our history of innovation.In almost every instance it is meant to empower employers, doctors andindividuals with better information to make more informed health decisionsthat may lead to better health.

Information We support doctors, consumers and employers with oneof the largest collections of clinical data in the world.Our analysis aims to transform raw data intomeaningful information people can actually use toexperience better care and live healthier lives.

Decisions Our core values rest on a belief in the power ofinformed decisions. So we’re continually designinginformation tools and technology that make it easierfor consumers to take a more proactive role in theirday-to-day health decisions.

Health Our extensive clinical data and advanced analytics aredesigned to:� Promote the use of health professionals andfacilities who deliver care supported by the latestclinical research.

� Identify individuals at risk for health conditions likehigh blood pressure or diabetes and alert their doctors.

� Share insights from our claims data with doctorsand hospitals.

Bringing change to lifeInnovation means nothing without the power to execute. Our creativesolutions come alive through:

� Thoughtfully designed products

� Large national network

� Commitment to excellent member service and employer administration

Information: lightingthe path to better healthInformation that mattersWe deliver information that matters. So doctors can see theimpact of their clinical practices; so employers can know thebest way to structure their benefits plans; and so we can identifypotential member health issues sooner. That’s how informationcan help improve health care quality, minimize the risk ofcomplications and reduce health care costs.

Informed clinical performanceWe provide network physicians with their own performance datadown to the individual patient level. Their performance is thenmeasured against nationally accepted practice guidelines, andagainst their local and national peers. Our experience shows thatsharing data with physicians whose practice patterns differsignificantly from their peers has led to a 24 percent increasedadherence to evidence-based medicine guidelines.3

Identifying at-risk individuals soonerOur latest innovation, the eSync PlatformSM, is a proprietarytechnology that synchronizes health care data from manydifferent sources. The eSync technology uses different kindsof health data to build a detailed health portrait of each personwe serve. Those profiles help prioritize nurse outreach to peoplewith health risks or those who are facing complex health caredecisions. This individualized education and counseling helpspromote better health for individuals – and better resultsfor employers.

3 UnitedHealthcare data analysis of physician practice patterns - 12 months post data sharing.4 Treatment Decision Support Book of Business; OptumHealth, Jan-Aug, 2009

The Treatment Decision Supportprogram identifies people facingcomplex health care decisions forconditions having wide variationsin treatment costs and outcomes.Then our nurses reach out tothem to provide information onevidence-based medicine andany risks associated with theirvarious treatment options. Asa result4:

� 15 percent of membersdiscuss with their doctorsalternate procedures; and

� 22 percent chooseUnitedHealth Premium®

designated specialists –doctors who have met nationalguidelines for quality care.

The powerof information



Supporting informed health decisions

5 How Engaged Are Consumers in Their Health and Health Care, and Why Does It MatterResearch Brief No. 8, October 2008, Center for Studying Health System Change; www.hschange.com/CONTENT/1019/

Staying healthy

Wellness programs� Online health assessment helps members understand their lifestyle andhealth risks while recommending preventive steps and lifestyle changes.

� Online health coaching programs motivate and guide individuals to makelifestyle choices that may result in improved health and well-being.

� Reminder mailings recommend preventive care and screenings.

� Healthy pregnancy program supports expectant mothers through all stagesof pregnancy.

Living with illness

Chronic and complex condition management� Case management nurses reach out to members with asthma, coronaryartery disease and diabetes (among other diseases).

� Complex condition management provides access to leading health carefacilities and services to support safe, cost-effective care for transplants,congenital heart disease, kidney and neonatal services.

Getting healthy

Care management and decision support� The NurseLineSM or Care24® program offers toll-free 24-hour access toregistered nurses who can assist with health-related concerns.

� UnitedHealth Premium® designation program gives members informationabout doctors and specialty centers that meet or exceed national guidelinesfor quality.

� Care management services mobilize appropriate care resources for membersby identifying gaps in care, like missing medications or misunderstandingcare instructions.

People who are actively engaged in managingtheir health are more likely to make good healthdecisions.5 Every UnitedHealthcare medical planis designed to promote and support exactly thiskind of positive member engagement.

People who are actively engaged are more likelyto seek preventive care, watch their diet, exercise,monitor their health conditions and adhere to

treatment protocols. They even ask morequestions, which means they can have greatersuccess in navigating a highly complex and oftenconfusing health care system.5

We put the power of information to work to helppeople get actively engaged, make more informedhealth decisions and take responsibility for theirown health.

We offer three distinct kinds of health and wellness support:


Supporting improved health outcomesNot all health care is created equal. So ourapproach to better health includes twoessential steps:

� First, we share the clinical insights from ourclaims data with doctors and hospitals tosupport clinically accepted practice patterns.

� Second, we share our experience withmembers so that they can make informeddecisions when it comes to choosing doctorsor facilities that meet quality and cost-efficiency guidelines.

Sharing clinical insights with doctors andhospitals: UnitedHealth Practice Rewards®

We provide physicians with feedback on theirpersonal practice patterns, including detailedpatient reports. Doctors can use thisinformation to monitor their clinicalperformance and administrative efficiency.

Sharing our experience with members:the UnitedHealth Premium®

designation programThe UnitedHealth Premium designationprogram recognizes physicians for meetingquality and cost efficiency criteria across20 distinct medical specialties. The programguides members to health care professionalswho demonstrate that they adhere to evidence-based medical guidelines for increased qualityand efficiency.6

Building awarenessGetting members engaged with Premiumdesignated physicians is the first step towardensuring that they can find quality care whenthey need it. That’s why we provide employeeeducation campaigns using online tools,e-mails and printed materials that describethe UnitedHealth Premium designationprogram and its benefits.

Proactive connectionsOur sophisticated information systems builddetailed health profiles of each person we serve.Based on those profiles, our outreach nursescan deliver customized information aboutappropriate Premium designated physiciansdirectly to people who are facing complexhealth care decisions.

In cardiovascular surgery we’ve found6:

� 59 percent lower complication rates forUnitedHealth Premium surgeons ascompared with other surgeons who didnot receive the quality designation

� 64 percent fewer redo procedures forUnitedHealth Premium surgeons comparedwith other surgeons who did not receive thequality designation

6 UnitedHealthcare claims analysis, 2007

� Employers can expect an average savings fromone to three percent of annual medical spending.

� Doctors who meet quality and cost efficiencycriteria have costs that are 15 percent belowmarket average.

UnitedHealth Premium results6:


Hospital Comparison ProgramMembers in many areas of the country alsohave access to hospital quality and efficiencydata online through our Hospital ComparisonProgram.The Hospital Comparison Programprovides cost and quality information on 50inpatient conditions and procedures. Hospitalquality and cost information is compared withnational quality norms and local cost norms tohelp consumers make an informed choice aboutthe care they receive.

The quality and cost data include informationon hospital performance in areas such as:

� Patient volume

� Unfavorable outcomes

� Mortality rate

� Length of stay

� Average charges

� Safety practices

Information that makes a differenceUnitedHealthcare believes that offeringcredible, understandable information empowersmembers to make more informed decisions, andmay help health care professionals to deliverhigh quality care at the lowest price. TheUnitedHealth Premium program also supportsphysicians and facilities in their efforts toimprove the care they deliver by providing themwith rigorous feedback reflecting their overallperformance and detailed patient reports.

UnitedHealthcare makes it easier for people tofind a doctor and understand how their choicescan influence the quality of the care they receive– and your overall costs.

7 HealthGrades Patient Safety Study, April 2009

Did you know that patients attop-performing hospitals are43 percent less likely toexperience a medical error?7


Products for every needYour company has priorities and goals that will drive yourspecific benefits strategy. You can trust UnitedHealthcare tomake your strategy a success with products that can helpemployers maintain a healthy and productive workforce –while delivering significant cost advantages.

With our national network and administrative platforms,you can have one consistent plan design for every location –or as many plans as you have locations. It’s up to you.Whether you need one plan or many, you get one fullyintegrated system to simplify your administrative functionsand deliver seamless service.

Ask about our plan designsthat provide lower office visitcopayments and greater plancoinsurance coverage whenemployees find care providedby UnitedHealth Premiumdesignated doctors.

TraditionalPlans�

Proven, familiarplans offeringbroad freedom ofchoice.

Full range ofmedical benefitsand networkaccess.

Consumer-Driven Plans

�

High deductibleplans withfinancial accounts.

Engagementtools to increaseemployeeownership oftheir health.

Value-BasedPlans�

Financialincentives andengagement toolsto encouragememberresponsibility andbehavior change.

EssentialBenefits

�

Lower cost healthcare coveragebased onlimitations in:

• Network access

• Benefit coverage

RetireePlans�

A variety ofcoverage optionsfor employeesenteringretirement.

InternationalPlans�

Plans for UnitedStates expatriatesand foreignnationals.

Supplement your plan with additional coverages like pharmacy, dental, vision, life and disability

Choose the plan that meets your needs


Extensive network accessA large network can help control costs and maximize employee benefits. Since 98 percent8 ofAmericans can access our network, your employees can easily see a participating doctor. That’scritical because we estimate that for all services combined (inpatient, outpatient and professional),using the network results in an average reduction off billed charges of 40 to 55 percent.9

8 Full-Year 2008 Nationally Recognized Third Party Benchmarking Data9 UnitedHealthcare Non-Network Programs At-a-Glance, Sept. 200910 Note: Maximum Non-Network Reimbursement and Shared Savings Programs may not be available in all areas or for all group sizes.

� 645,000 doctors andhealth professionals

� 5,105 hospitals� 64,000 pharmacies� 1,000 conveniencecare clinics

� Includes 2 out of 3available health careprofessionals across thecountry

� 95,000 specialistsdesignated for theirquality care

We make it simple to build the benefits planyou need with the largest single, proprietarynetwork of doctors and hospitals in the nation:

Other cost saving measuresPhysicians and facilities that aren’t in ournetwork set their own prices. The result can behigher billed charges for employers and higherout-of-pocket costs for members.While ourextensive network will always provide the bestquality and value to your employees, if youremployees do choose to go to a non-networkdoctor or facility, we offer two non-networkprograms to help control costs.

Shared Savings Program10

Our Shared Savings Program contracts withthird party vendors to access and negotiatediscounts on services received from non-network health care professionals. The averagesavings is 15 to 35 percent off of thephysician’s or facility’s billed charges.9

MaximumNon-NetworkReimbursement Program10

This program caps certain eligible expensesfrom non-network physicians and facilitiesat a maximum amount based on the paymentmethodology used by Medicare. This fixedmaximum helps control medical trendand reinforces to members the value ofseeking services from network healthcare professionals.

Whether your employees choose network ornon-network care, we’re always looking forways to save you and your employees money.


Award-winning serviceYou expect your benefits plan to execute the basicadministrative services at an extremely high level;things like paying claims, answering member calls,and minimizing paperwork.When you chooseUnitedHealthcare you’ll appreciate the care andattention to detail we bring to these vital tasks:

� Seamless set-up of your benefit plan by your caseeffective date.

� Easy online administration through EmployereServices®, our secure administrative website thatallows you to add or delete enrollees, checkclaims, pay bills and more – all online, anytime.

� Knowledgeable service professionals who resolveissues on the first call 94 percent13 of the time.

� Multiple channels to answer employee questions– by phone, and through our member website,myuhc.com®.

� Claims paid accurately over 99 percent13 ofthe time.

We’re continually investing in our technology andour personnel so that our customers get the bestpossible customer experience. For example, we useinstant surveys and a behavioral analytics tool thatautomatically audit customer calls so supervisorscan coach call center staff. Tools like these arehelping us to take service and call quality to anentirely different level.

11 American Customer Satisfaction Index (ACSI) Q1, 201012 Business Insurance, Fifth Annual Readers’ Choice Award, 200913 Internal claims analysis, 2009

Contact your broker orUnitedHealthcare representative todayto put UnitedHealthcare’s innovativecapabilities to work for you.

� UnitedHealth Group received first place ininsurance category for the AmericanCustomer Satisfaction Index (ACSI).11

� UnitedHealth Group was named “BestHealth Plan Provider” by the readers ofBusiness Insurance in the magazine’s annualReaders Choice Awards.12

Today’s business world demands motivated, creative workers to produce top qualityresults and lasting client relationships. Benefit plans from UnitedHealthcare are designedto match individual health needs with customized care support, which may result in ahealthier and more productive workforce.

Our hard work is paying off:

The Healthy Pregnancy Program follows national practice standards from the Institute for Clinical Systems Improvement. The Healthy Pregnancy Programcan not diagnose problems or recommend specific treatment. The information provided is not a substitute for your doctor’s care.

NurseLineSM nurses cannot diagnose problems or recommend specific treatment and are not a substitute for your doctor’s care. NurseLine services are not aninsurance program and may be discontinued at any time.

The Care24® Program integrates elements of traditional employee assistance and work-life programs with health information lines for a comprehensive set ofresources. It is not a substitute for a doctor’s or professional’s care. Due to the potential for a conflict of interest, legal consultation will not be provided onissues that may involve legal action with UnitedHealthcare, or its affiliates, or any entity through which the caller is receiving UnitedHealthcare, or its affiliates,services directly or indirectly (e.g., employer or health plan). The Care24 Program and its components may not be available in all states or for all group sizesand are subject to change. Coverage exclusions and limitations may apply.

The UnitedHealth Premium® designation program is an information resource to help our members choose a physician. It may be used as one of many factorsmembers consider when choosing the physicians from whom they receive care. As with any performance assessment program, physician evaluations have arisk of error. For a complete description of the program, including details on the methodology used, geographic availability, program limitations and medicalspecialties participating, please see myuhc.com®.

The hospital comparison program uses data from publicly available data sets, UnitedHealthcare claims and hospital data from Leapfrog and CMS, to create amultidimensional view of hospital performance. Not all facilities are eligible for evaluation for the program.

The hospital comparison program is intended as a resource for informational purposes only. UnitedHealthcare does not provide health care services orpractice medicine. Physicians are solely responsible for medical judgments and treatments. Inclusion in this program does not guarantee the quality of carebeing rendered. All physicians and facilities that contract with UnitedHealthcare have met credentialing requirements. Regardless of rating, plan enrolleeshave access to all physicians and facilities in the UnitedHealthcare Network.

For a complete description of the hospital comparison program, including details on the methodology used, geographic availability and program limitations,please see myuhc.com.® Specialty benefits and programs may not be available in all states or for all group sizes. Components subject to change.

Insurance coverage provided by or through UnitedHealthcare Insurance Company or its affiliates. Administrative services provided by UnitedHealthcareInsurance Company, United HealthCare Services, Inc. or their affiliates.

100-6359 11/10 Employer ©2010 United HealthCare Services, Inc.

www.unitedhealthcare.com

To learn more about

UnitedHealthcare’s

innovative capabilities,

please contact your broker

or UnitedHealthcare

representative.

UnitedHealthcare Overview Brochure

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