The UMR
Advantage
A unique solution for
the self-funded market
The value and advantage of UMR
We are the only TPA that:
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Offers the significant network discounts and infrastructure investment
of a Fortune 50 company
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Offers fully integrated internal benefits solutions, such as care management,
pharmacy benefits administration and stop loss; or can plug and play with
your preferred vendors
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Can quickly respond to state and federal mandates, regulators and market
changes
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Most of all, we know how to put Customers First.
We call it the UMR advantage.
As a UnitedHealthcare company, UMR has access to significant network discounts from
the broadest network in the country; powerful technology that allows us to easily comply
with state and federal mandates, as well as bring new services to bear, and capital
investment in our capabilities.
Only UMR can offer the significant discounts of the UnitedHealthcare networks. But we
also have relationships with more than 100 other PPO and PHO networks.
We have fully and tightly integrated internal solutions—clinical services, stop loss,
pharmacy—that offer proven service and savings.
Finally, we bring the advantages of a TPA with a dedicated service model that both
answers calls and pays claims, so your members get accurate information quickly. You
get an assigned account management and support team to deal with daily, as well as on
more strategic issues and plans.
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©2012 United HealthCare Services, Inc.
What you should know about us
We’re big. But we’re also local and regional in scope with claim offices in each time
zone and account management staff in just about every state, close to our customers.
We have more than 3,000 people who can focus their expertise and experience on
your plan.
We serve more than 1,400 customers and their more than 2 million members every
day – accurately, carefully and compassionately. Our customers range from mid-sized,
self-funded companies to coalitions of employers to large state governments.
You should know, we treat each one with the same amount of care and expertise.
Most of our customers ask us to administer multiple, unique plan designs with various
reimbursement methods …
It’s what we do best.
Our claim centers are located across the country—from Seattle to San Antonio to
Cincinnati to Wausau, Wis. Additionally, we have smaller centers in Des Moines, Iowa,
and Rockford, Ill.
With more than 100 account management staff, it’s likely yours will be in driving
distance of your office.
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©2012 United HealthCare Services, Inc.
A solution for all self-funded clients
In the evolving world of health care, UMR is a sophisticated partner who understands the
marketplace and can provide innovative responses to new regulations, industry trends
and customers’ changing needs. We have seen everything the market has had to offer,
and we’ll work with you to incorporate new solutions, realize additional efficiencies and
develop a long-term vision for helping you grow and adapt.
Clients come to us because they are looking for a strong partner who listens … who can
help them design a benefit plan that works specifically for their unique situation … who
delivers financial and claim accuracy … who offers a service model based on — well,
service.
More than 95 percent of our clients not only renew with us, they recommend us to other
organizations. They appreciate the exceptional service, solid savings and thought
leadership UMR offers.
UMR is a great solution for all self-funded organizations.
Additionally, we have a particular understanding of some specific industries:
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Hospitals and health care systems - Expertise on supporting three- and fourtier designs, promotion of domestic utilization
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Native American - Expertise on coordinating Medicare-like rate re-pricing,
domestic pharmacy pricing, hybrid care management models
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Labor/trusts - Expertise on collectively bargained welfare benefit plans
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Retirees - Expertise on working with retirees,
dedicated claim teams with specialized training
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Coalitions - Experience and expertise
on the complex relationships
and value of coalition members
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Public sector - Experience and
expertise working with states,
cities, counties and school districts
©2012 United HealthCare Services, Inc.
The savings power of UnitedHealthcare’s
resources and network: Network strategy
We provide best-in-class solutions, including full networks that offer strong and stable
contracting, exceptional access and some of the best discounts available.
Our network strategy is successful primarily because, along with having flexible choices,
our network team listens closely to our customers. We seek a clear understanding of
what a customer values and then work through which strategy will help them meet
their goals.
Once UMR’s network team gains insight into what a customer really wants and needs,
we partner with them to deliver a solution. We can do that because, at the same time,
we are partnering with our vendors to understand and recommend the many solutions
that are out there.
One of our biggest advantages is, of course,
being a part of UnitedHealthcare.
UMR is the only TPA with access to the UnitedHealthcare networks!
UnitedHealthcare has the country’s largest proprietary network with comprehensive
national access. Our national reimbursement rates are:
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Inpatient over 85 percent on DRG and per diem basis
Outpatient over 80 percent per visit and per case basis
Primary physicians and specialists over 95 percent fee schedule basis
©2012 United HealthCare Services, Inc.
The networks continue to grow
UnitedHealthcare is constantly expanding through additional provider contracting, but it’s
more than just adding providers — it’s about keeping providers. We have established
long-term contracts (three to five years) with our network providers, and 99.6 percent of
hospital spend remains under contract or renews annually without provider disruption or
notice.
This focus on fixed-rate contracts helps us predict and control future costs.
UnitedHealthcare has a specific set of development objectives for each market area.
Specific hospitals and physicians that customers want or need to build greater depth into
the network will be targeted, so it will just keep getting better.
Additional network advantages include:
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Significant out-of-pocket savings and no-balance billing with in-network providers
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Simplified administration for multi-site customers
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Seamless integration of specialty products and services
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Single, toll-free telephone number to access benefit, provider and claim
information
©2012 United HealthCare Services, Inc.
Claim savings analysis
UMR has a dedicated support team to help with network issues and concerns. They
work directly with local UnitedHealth Networks (UHN) contractors on access issues
and network development. We have direct access into UnitedHealthcare’s re-pricing
system to assist with discount disputes and appeals. We can also help members find
network providers and assist with specific network arrangements. We will work with
our local UHN contractor to facilitate direct customer/network arrangements.
When we determine that UnitedHealthcare’s Options network is a good choice for a
client, it’s because we can see substantial savings.
In this real life example below, one of our clients was experiencing a
31.4 percent savings on claims with their old network. Just by switching to Options,
where their members have access to fully credentialed physician specialists and other
health care providers, this client saved 49.3 percent.
Of course, it’s not just about discounts. The Options PPO network provides our
customers with the flexibility they expect from a TPA. Options PPO network
accommodates most benefit plans. Steerage requirements are less restrictive,
and we have the ability to quilt in other networks, when necessary.
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©2012 United HealthCare Services, Inc.
And, there’s more!
Because we have relationships with more than 100 other PPO and PHO local and
regional networks, along with access to multiple national networks, we can provide
access and savings to clients whose plan members may be located in areas not well
served by UnitedHealthcare networks. We can mix and match these networks, as
needed. This is what sets us apart from carriers and other TPAs.
The UMR network contract administration and analysis team works directly with UHN and
our other network partners to balance customer needs with network rules. Strict
confidentiality and security firewalls allow us this network flexibility.
880,000 of UMR’s 2.3 million members access non-UnitedHealthcare networks. As we
mentioned, we offer quilting of networks to provide employees access to providers when
a single network won’t do that.
An example:
A customer in Madison, Wis., who uses only one network likely has employees
without access to the University of Wisconsin System, a leading provider in the
community. UMR can quilt a regional network that includes the UW System and fill
in the gap in coverage.
UMR also offers a variety of dental networks. Dental network savings can often offset
medical cost increases. We also know that with dental networks, access is the No. 1
priority. We give our customers a broad-based solution by combining the UMR Managed
Dental network with Connection Dental.
UMR’s goal is to understand your network
strategy and provide recommendations to
improve your competitiveness, as well as
seek out new networks and network
products. We will help you select the best
network, and negotiate contracts and
network access fees on your behalf.
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©2012 United HealthCare Services, Inc.
Cost reduction and savings program
Our cost reduction and savings (CRS) program helps you save money on
non-PPO/out-of-network claims. Our secondary network strategy provides
access to thousands of contracted providers nationwide through the
First Health or Multiplan Complimentary networks.
If we cannot obtain a secondary network discount, the claim will be sent to
OptumInsight (formerly Ingenix) for fee negotiation, or to Corvel for facility
usual and customary (U&C) review.
OptumInsight offers a post-claim fee negotiation service for claims
with an allowed amount of $1,000 or more. This fee negotiation
strategy provides complete and transparent claim resolution, which
is contracted in writing and eliminates balance billing of members.
For Corvel facility U&C, all claims with a billed amount of $1,000 or
more are reviewed for accuracy in coding, re-bundling, re-pricing,
reasonable and customary or fee schedules.
Corvel may also flag claims for professional nurse review or enhanced bill
review. Corvel makes a U&C determination; therefore out-of-network providers
may bill members for charges over and above U&C. To limit balance-billing for
members, Corvel asks the provider to write off the amount determined to be over
U&C. Corvel also asks the provider to call them directly with any questions about
the reimbursement amount.
Our Maximum Non-Network Reimbursement Program (MNRP) offers
customers a more aggressive option for out-of-network cost reduction by
applying Medicare-based rates to claims in place of standard facility or physician
U&C. Member awareness of health care costs is promoted and members are
encourage to change behavior, using their PPO network whenever possible.
Physicians and facilities are encouraged to contract with PPO networks.
The member is responsible for deductible and coinsurance, as well as the
difference between billed charges and the MNRP allowable.
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©2012 United HealthCare Services, Inc.
A proven record for saving money
While not all eligible claims will receive a discount, UMR makes every effort to attain a
discount and reduce your claim costs. UMR’s secondary network arrangements attain an
average discount of 27 percent, while our fee negotiations garner 20 percent and facility
U&C 30 percent.
Because the monthly fee is based on percent-of-savings,
the CRS program is truly win-win. Nearly all stop loss carriers have
agreed to consider the CRS program fees as reimbursable expenses under the stop loss
contract, so the fees accumulate toward your contract maximums — the specific
deductible and aggregate claim maximum.
The total cost of your UMR self-funded plan is therefore reduced by the CRS program.
This is a standard offering for all customers, not an option.
90 percent to 92 percent of all claims are PPO. Of the remaining 8 percent to 10 percent,
non-PPO claims, about half will hit the secondary network strategy. Only 2 percent to
3 percent of the non-PPO claims actually engage Corvel for facility U&C review.
10 ©2012 United HealthCare Services, Inc.
Customer Solutions — network team
Our work is not over when a network is selected.
The Customer Solutions — network team is a valuable resource for customers and
prospects to develop and support their network strategy. UMR will monitor performance on
your behalf to maintain appropriate access to care, responsive service and competitive
savings. Such ongoing support ensures compliance with the network rules and allows
analysis and review of your network strategy. UMR also provides:
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Custom network setups
ID cards
Member communication for network education
Compliance with network confidentiality and security
The Customer Solutions — network team is a dedicated resource for customers to help
develop initial and ongoing network strategies and resolve network issues. We initially
maintain demographic and discount data on more than 45 networks, allowing us to tailor our
network strategy to customer needs and goals for provider access and discounts.
When recommending a strategy, we consider stability, minimizing employee disruption as
they transfer to the new network. We focus on marketing, analysis and administration of our
networks, maintaining strong relationships with them. Because we understand the
requirements, strengths and weaknesses of our network partners, we can educate our sales
and account management teams, as well as our clients. We continually investigate and
consider new networks and products that make sense for our customers.
We work to assure our network partners and customers who have built and maintain their
own networks that their proprietary information is not shared with UnitedHealthcare. Their
trust in our commitment to this confidentiality is a large reason we maintain these
relationships and are able to offer multiple network solutions. These relationships also
allow us to leverage our membership with our networks on behalf of our customers. It’s
often easier for UMR, with perhaps 35,000 employees in a network, to resolve an issue than
it is for a single client who has only 100.
11 ©2012 United HealthCare Services, Inc.
The flexibility and service focus
expected from a TPA: Core capabilities
A key factor of the UMR advantage is that we are, first and foremost, a TPA, so one of our
strengths is that we, of course, offer the flexibility and personalized service of a TPA.
Although we serve more than 1,400 customers (most of whom have multiple plan designs),
we clearly understand that each customer is a unique organization with a different culture,
varying short- and long-term strategies and distinct approaches to plan design and cost
containment. Our customers appreciate that we don’t have a one-size-fits-all approach, and
as a result we build long-term relationships.
We work to:
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Understand each customer’s unique needs and company culture
Promote familiarity with customers, their plan and their employees
Be accountable for service delivery and improved plan results
Our Customer First business model ensures accountability is embedded across your
service team. This detailed approach means we get it right the first time. We take our time
training the Customer First representative (CFRs), starting with six weeks in the classroom,
followed by a full month on the job with limited authority, concentrated audits and close
mentoring.
And as we administer your plan, we conduct individual audits in claim and call. Each CFR
has five calls recorded every week to review service accuracy and quality. We conduct a
corporate audit of each service office to make sure our company standards are met for
processing accuracy.
UMR provides monthly and sometimes daily or weekly reports for claim transactions, check
registers, care management and (if you opt for OptumRx) prescription usage online. We
supply quarterly standard reports, as desired, using Advantage Suite by Thomson Reuters
and an annual Plan Performance Analytic Review that merges clinical findings with claim
costs and trends against normative data for use in strategic planning or modifying benefits.
12 ©2012 United HealthCare Services, Inc.
Member support
Our operations model is built around the plan members and customers to meet their needs
in the most efficient manner. Taking care of plan members is critical to plan sponsor
satisfaction, so we concentrate on providing accurate, fast and compassionate service.
Each client is assigned a dedicated team that’s focused on accuracy and turnaround.
They get to know each plan in detail and often get to know members by name.
CFRs answer the phones and pay claims so they have all the information they need to
respond quickly to a call. We find this approach results in more than 90 percent of
inquiries resolved on the first call. On average, each CFR has more than six years of
experience and takes ownership for their customers.
The CFRs are joined by customer specialists who solve day-to-day claim issues and work
with experts throughout UMR to maintain quality in our daily operations. We maintain a ratio
of 2,300 plan members to one CFR. The team also includes a claim supervisor.
Care management nurses, as well as disease management and wellness coaches, provide
members with ongoing support to live as healthy a life as possible. Our care management is
integrated with claim operations, so UMR provides seamless member interaction that
increases first-call resolution.
If a client chooses consumer-driven (CDH) plans or value-based benefit designs, UMR
offers a trained Consumer Concierge to act as their advocate and provide cross-functional
customer service (medical, CDH and dental), beginning at pre-enrollment and continuing
throughout the life of the plan.
Our pharmacy services partner, OptumRx, has dedicated UMR resources and user-friendly
Web and mobile tools to boost member compliance. UMR also has strong online tools to
help members keep track and understand their benefits and monitor not only their claims
but their own health.
13 ©2012 United HealthCare Services, Inc.
Customer support
On the plan sponsor side, each customer has a dedicated strategic account executive (SAE)
who becomes an expert on that client’s culture, objectives, benefit strategy and expectations.
SAEs hold an authoritative role within the UMR structure. They are able to influence decisions
and provide superior, proactive service in managing accounts. Bilingual SAEs are available.
SAEs are accountable for their client’s overall satisfaction and:
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Partner with clients and their advisors in enhancing their plans and savings through
ongoing analysis and regular results meetings
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Are a single point of contact for escalated issues and liaison between clients and UMR
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Have self-funding knowledge
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Hold a strong partnership with account executives
SAEs are supported by customer specialists who:
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Solve day-to-day claims issues and escalated, complex customer service challenges
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Work with experts throughout the organization to maintain quality of daily operations
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Provide technical expertise to the team
Client service consultants support the SAE and, of course, the client in service delivery. They:
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Support clients and their SAEs in day-to-day questions or issues
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Partner with the SAEs in service delivery and tasks for the account
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Are key facilitators for tracking, fact gathering, and information delivery such as reports,
contracts, plan summaries and ID cards
14 ©2012 United HealthCare Services, Inc.
Specialized support
Customer First teams have access to specialized teams who designate contacts by
customer to increase accountability and familiarity.
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Reporting and analysis – provides access to online reports supporting financial
reconciliation and facilitating strategic decision making
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Care management – integrated with claims operations, which creates seamless
member interaction and increases first-call resolution
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Ancillary services – provides access to best-in-class ancillary services,
including vision, hearing and telemedicine products
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Stop loss – focuses on delivering the best carrier and contract type with quick
claims filing and reimbursement
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Consumer-driven solutions – a comprehensive approach that increases
consumer engagement while reducing overall medical trend
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Claims – dedicated team that’s focused on accuracy and turnaround while
working to maximize your savings on today’s claims costs
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Network administration – focused on maximizing the access and savings
associated with local, regional and national networks
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Pharmacy benefits -- a preferred relationship with our sister company OptumRx
offers the best integration, flexibility and lower prescription costs.
15 ©2012 United HealthCare Services, Inc.
Customer First delivers results
Customer First teams drive accountability, resulting in timely,
accurate claims processing as shown by the results below.
We also externally validate our results through annual SAS70 audits. We audit 3.5 percent
of our claims.
Additionally, we conduct regular customer satisfaction and account management surveys,
provide performance guarantees and use consistent feedback metrics.
UMR’s auto-adjudication rate is greater than 75 percent, and more than 70 percent of our
claims are submitted electronically, which further improves accuracy.
16 ©2012 United HealthCare Services, Inc.
A reputation for smooth implementations
Transitioning to a new TPA can sometimes be a barrier to making a change. At UMR, we
understand how important a smooth implementation is, and we pride ourselves on a
successful and — if we say so ourselves — impressive track record.
We assign experienced transition leaders who oversee a
full team that includes:
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The strategic account executive
Claim management
Supervisors
Technical experts from each of our business units
All our teams, and especially our transition leaders, are experts at dealing with
unexpected issues without jeopardizing their deliverables.
We keep detailed implementation logs, assigning each and every deliverable and task a
target date and an owner who is held accountable. Management also plays
an active role.
As the implementation moves along, this team evolves into an ongoing service team —
so they understand the issues and the complexities of your plan better than anyone else.
17 ©2012 United HealthCare Services, Inc.
Tightly integrated internal solutions:
Care management
UMR Care Management provides integrated, member-centric services that can
be tailored to your overall strategy. We help employers develop multi-year strategies to adapt
their health culture to value healthy lifestyles, emphasize personal accountability and, ultimately,
mitigate their medical claim trend. We focus on educating and motivating members, moving them
from incentives for participation to incentives based on achievement of empirical, clinical health
markers, such as BMI, LDL, fasting glucose and blood pressure.
We equip your plan members with the knowledge and resources to take a more active role in
their health care decisions and to think like consumers when choosing the right options for them.
UMR recognizes that when it comes to member care, one size does not fit all – a service of
utmost value to one plan member may be of little or no value to another. Incentives, such as
reduced co-pays or premiums, reward members for appropriate use of high-value services or
adopting a healthy lifestyle.
Government estimates show as much as 75 percent of health care costs can be attributed to a
preventable disease, so offering 100 percent coverage for preventive care may be a sound
investment. Preventive care, such as age- and gender-specific screenings, can detect these
diseases early, when they are most treatable, and help at-risk members make healthy lifestyle
changes to avoid developing a chronic and costly condition.
We can also offer value-based benefit solutions that combine the strength of our care
management programs with the benefits of consumer-driven health plans. The result is a plan
that uses incentives to steer plan members to the highest-value care at the most affordable rates.
18 ©2012 United HealthCare Services, Inc.
Keys to success
1. We have found that incremental, phased, multi-year strategies are the most effective in
achieving long-term, lasting change.
2. Senior-level support is essential to building and sustaining wellness initiatives. Senior leaders who
communicate the wellness message frequently have more effective and results-oriented programs,
because support from the top tells employees that wellness is a priority at your organization.
3. For these programs to be successful, plan members need to not only be aware of them but
educated and engaged in them. Communication is critical. UMR care management will help you
develop and deliver a coordinated communication plan that connects with members at multiple
levels through print, electronic, telephonic and multimedia messages.
4. Incentives, particularly financial rewards, such as premium reductions or gift cards, are powerful
motivators for encouraging member behaviors that are aligned with your objectives. The right
incentive can:
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Spur interest
Help your program maintain momentum
Raise your participation level to better than 70 percent over time
We recognize that every member population is different, so we will work with you to customize an
incentive plan that best meets your needs and those of your members. Consider adopting an
incentive plan that evolves with time, moving from a program that rewards participation to one that
rewards improved health indicators, such as biometric screening results. Once established,
consider enhancing wellness activities by incorporating consumer-driven elements or valuebased designs.
19 ©2012 United HealthCare Services, Inc.
The value of our care management program
Our suite of care management products offer tightly integrated internal
solutions to medical management, but we also have the flexibility to “plug and play” with just
about any vendor a client prefers.
We can give you access to the full spectrum of URAC-accredited programs – from utilization
management and case management to disease management and health and wellness.
Each program is interconnected and linked to our sophisticated claims platform. Or you can
pick and choose only those products that fit your unique needs.
To make the most of your medical plan and take full advantage of the discounts available to
you through the UnitedHealthcare Options PPO Network, UMR requires you to use our
utilization management and case management solutions to limit potentially costly claims.
When purchased in a combined package, our customers typically realize a 3:1 return on
investment for our utilization management, case management and disease management
programs.
There’s no silver bullet to our approach, but it is designed to connect with plan members and
energize them to actively participate in their health care decisions and lifestyle choices.
20 ©2012 United HealthCare Services, Inc.
The member experience
UMR Care Management works with members to:
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Actively engage them in their health and health care decisions
Help them understand how to get more value for their health care dollars
Improve their daily behavior to enhance their quality of life
Members have an advocate who helps them navigate the health care system and their benefits
options in a knowledgeable, friendly and caring manner. Our programs emphasize communication
and education, participation, member satisfaction and clinical improvement. Members receive the
tools they need to build stronger relationships with their health care providers, along with
informative materials on important health topics and access to online resources.
Working hand-in-hand with clients and client advisors,
we can drive participation through:
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Preventive care coverage
Plan inclusions and exclusions
Incentives tied to clinical health risk assessment (CHRA) or biometric screening completion
and health status, or incentives tied to participation with a health coach or case manager
We recognize that every member population is different, so we will work with you to customize an
incentive plan that best meets your needs and those of your members. UMR care management
provides a variety of member materials to help you introduce the programs and services available
to your employees and encourage them to make healthy lifestyle choices. These include posters,
flyers, tent cards, wallet cards, teleseminars, newsletter articles and lab screening handouts.
21 ©2012 United HealthCare Services, Inc.
Rewarding healthy behaviors
The right use of incentives will help you:
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Engage and reward members
Encourage completion of CHRAs and biometric screenings
Drive enrollment in health coaching programs
Spur interest in wellness-related activities
Influence behaviors
Maintain momentum
Place a clear emphasis on what’s important to the culture of your organization
Incremental, phased, multi-year strategies have proven most effective. Consider rewards
based upon:
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Activity/participation: Incentives for completing a CHRA or wellness coaching
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Diagnosis/risk: Co-pays waived on condition-specific medications, i.e., medicine
for hypertension management or cholesterol reduction
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Compliance: Lower premiums for non-smokers, 100 percent coverage for
preventive care or condition-specific care or medications
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Outcomes/health status: Incentives or benefits based upon biometric screening
results or improved screening measurements, or for achieving specific health goals
22 ©2012 United HealthCare Services, Inc.
Identifying member risk
UMR Care Management uses diverse sets of data and advanced analyses to identify
members with current chronic health conditions and future health risks.
After collecting the data, we examine the stratified results, using algorithms based on
standards outlined by nationally recognized health organizations.
When we’ve identified at-risk members — catastrophic, chronic or at-risk (non-chronic) —
it is important to engage them in the right program through plan design and targeted
member communications.
Members in the following categories are targeted to participate in one-on-one sessions
with a health coach or nurse:
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One of seven disease states: asthma, chronic obstructive pulmonary disease
(COPD), congestive heart failure (CHF), coronary artery disease (heart disease),
depression, diabetes and hypertension
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Pregnancy
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High-risk for developing heart disease
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High-risk for developing diabetes (pre-diabetes)
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Multiple lifestyle risks (nutrition, activity, blood pressure and/or weight/obesity)
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Tobacco use
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Body mass index of 35 or more (morbid obesity)
23 ©2012 United HealthCare Services, Inc.
NurseLine® and maternity management
NurseLine connects members with highly trained registered nurses any
time of day, seven days a week. Nurses help callers make more informed choices about
when and where to seek the appropriate care, providing information on specific
conditions and treatment options. This can result in fewer emergency room visits and
hospital stays, leading to lower overall health expenses.
Through NurseLine, members also can access an audio health information library, with
more than 1,100 recorded topics, such as aging, common illnesses, fitness and surgical
procedures.
Our maternity management program offers assessments and
information for women considering having a baby and prenatal education and guidance
to those expecting. The result is an increased number of healthy, full-term deliveries and
a decrease in costly, extended hospital stays.
We identify participants using claim edits, triggers and utilization review. Our nurse
coaches then provide education, follow-up calls and support based on
the woman’s individual risks. Those identified as high-risk are placed
into our case management program, to monitor their conditions
and keep customers informed of high-cost situations.
All members who join the maternity management program during
the first or second trimester receive an incentive gift. Once enrolled
in the program, expectant mothers are contacted by nurse case
managers who have extensive clinical backgrounds in obstetrics/
gynecology. Members also can choose from a selection of highquality books and other materials containing helpful information
about pregnancy, pre-term labor, childbirth,
breast feeding and infant care.
24 ©2012 United HealthCare Services, Inc.
Health and wellness
UMR’s health and wellness program provides a proactive
approach to improving the health of employees. We identify members’ current and future
health risks and then help them understand those risks and how they are linked to
conditions such as diabetes and heart disease. We give them the tools and support to make
healthier lifestyle choices that reduce their likelihood of developing a chronic disease.
Completing a clinical health risk assessment (CHRA) is the first step for members. Our
CHRA asks questions about members’ medical history and lifestyle habits such as food
choices, physical activity level, tobacco use and readiness to change.
We combine the CHRA reports with biometric screening results for blood pressure, glucose
levels and cholesterol to gain a more complete picture of the overall health of a group.
Members identified as high risk for future health problems are invited to work with a
personal health coach in a series of one-on-one phone conversations. Our coaches are
trained in behavior-change techniques and provide information and encouragement to help
participants set goals and follow through with their plan to live healthier.
UMR can assist you in establishing a workplace culture that supports healthy behaviors to
improve the well-being of your employees. We provide strategies and support in crafting
customized wellness plans, along with employee challenges that encourage participation in
physical activity, weight loss or healthy eating programs.
We encourage customers to attach incentives to their wellness programs. Incentives
increase participation and have a direct impact on your program’s success. Because every
employer population is different, successful incentive programs are structured with the
particular motivations of the members in mind.
The program includes:
Clinical health risk assessments
Onsite biometric health screenings
Personal health coaching
Quarterly newsletters
Educational information
Worksite wellness strategies and support
Incentive administration
25 ©2012 United HealthCare Services, Inc.
Disease management
UMR has found that these seven health conditions drive
medical claims costs for employers:
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Asthma
Chronic obstructive pulmonary disease (COPD)
Congestive heart failure
Coronary artery disease
Depression (co-morbid condition)
Diabetes
Hypertension (high blood pressure)
Identifying plan members and helping them manage their conditions provides the
maximum value to you, while helping participants improve their well-being. The program
also can mitigate indirect costs to you, such as absenteeism and reduced productivity.
Our program uses the leading behavior change model to determine an individual’s
current stage of readiness to change and how we can best guide the participant toward
improved health. To maximize your short-term return on investment, we focus on those
who are currently most ready to make a healthy change. Members with a chronic
condition are automatically enrolled in the program, and those identified for one-on-one
coaching are invited to participate through a combination of letters and phone calls.
To help drive participation in the program, UMR offers customers new to disease
management a $100 gift card incentive. It is given to eligible members who enroll in
one-on-one coaching during an introductory time period.
Lower-risk participants receive
a free subscription to our
quarterly newsletter and periodic
communications about their
condition and making healthy
changes. All members can access
NurseLine to talk with a nurse
about any health-related questions,
24 hours a day, seven days a week.
26 ©2012 United HealthCare Services, Inc.
Utilization management and
case management
UMR monitors all cases from initial notification through discharge. Our goal is to intervene
as early as possible to ensure cases don’t deviate from the expected treatment plan and
become complicated and costly for you or your employees. Cases that might be deemed
“high-risk” are forwarded to our case management or disease management programs
for further review.
We maintain an up-to-date list of inpatient and outpatient procedures that require
notification, and we can customize our list based on your specific requests.
We measure utilization management savings by comparing the estimated cost of the
care requested to the cost of care authorized. In most instances, our utilization
management program customers see a 2 to 1 return on investment (ROI)
approximately one year after the completion of program implementation.
UMR case management targets complicated cases to achieve better
medical outcomes for plan members and greater cost savings to you.The key to our
success is the case manager’s ability to identify, coordinate and negotiate alternative
treatment plans and related costs.
•
•
•
Our case management team is made up of licensed, registered nurses
95 percent of our nurses have certified case manager (CCM) credentials
All must have three years of acute care clinical experience and expertise in at
least one specialized field
Our system identifies case management opportunities using an automated trigger list that
can be customized at your request. The list is based on ICD, CPT and dollar threshold
criteria or when a member’s inpatient length of stay reaches five days. Each case
is unique and handled according to the specific needs of the
member. On average, cases remain open for four months.
UMR measures the success of its case management
program by the following criteria:
•
•
•
•
•
•
•
Improved clinical efficacy
Reasonable medical action plan
Coordination with providers and family
Clinically eligible for coverage
Customer satisfaction correspondence
Coordination with stop loss vendors
Return on investment
27 ©2012 United HealthCare Services, Inc.
Tangible results
UMR Care Management can provide data to support cost savings
based on risk reduction through comparison of behavior change and clinical outcomes.
Our programs put an emphasis on communication and education, participation,
member satisfaction and clinical improvement. As a result, customers achieve a
measurable return on their investment, including participation, clinical, utilization and
financial results.
When purchased in a combined package, our customers typically realize a 3 to 1 return
on investment for our utilization management, case management and disease
management programs.
In 2010, UMR’s book of business showed that for members who completed health
coaching:
•
•
•
•
•
•
39 percent improved their physical activity frequency
25 percent state they have less life stress after coaching
32 percent stopped tobacco use during coaching
34 percent showed improvement in blood pressure
44 percent stated they eat high-fat foods less frequently
44 percent stated they eat high-fiber foods more frequently
By working with UMR’s health coaches, disease management participants overall are
able to improve or maintain their health status for nearly 75 percent of the clinical risk
factors measured.
28 ©2012 United HealthCare Services, Inc.
Tightly integrated internal solutions:
Pharmacy
Research studies show time and time again,
that the most frequently accessed portion of
one’s health care benefits is prescription drug
coverage. UMR offers a unique and preferred
internal PBM pharmacy benefits manager —
which has been paramount to achieving overall
cost control and high member satisfaction.
Pharmaceutical trends are complex and
rapidly evolving. Having a thought leader in
the PBM arena is vital. A number of factors
are influencing the 5 percent to 7 percent
growth in drug sales estimated by IMS Health.
That translates to $880 billion in global drug
revenues for 2011. Actual U.S. prescription
drug sales grew 5.1 percent in 2009 to
$300.3 billion.
Affecting this growth is the fact that a number of new “first in class drugs” were released in 2011
for conditions previously under-treated — such as multiple sclerosis (MS), Hepatitis C, prostate
and bone cancer (plus osteoporosis treatment), and thefirst oral anticoagulant in 50 years.
Generics
“Many of the world's biggest-selling drugs are set to lose U.S. patent protection from 2011-2014,
leading to massive savings,” of an estimated $70 billion over the next four years. Generics are also
expected to increase their market dominance, rising from 77 percent of prescriptions in the first half
of 2011 to as much as 85 percent by 2014, according to the new forecast. Many iconic brands will
lose patent protection in 2011-2014 (six of the top 10 brands), such as Lipitor and Plavex.
Public and private controls
Canada is eliminating rebates. In the U.S., we are seeing increased use of PAs by payers/health
plans. Companies are cutting benefits and encouraging patients to use the lower cost alternatives
through incentives. Global price setting limits pharma profits in Spain, Turkey and Japan.
Emerging new players
The U.S., Japan and China will be the top three players by 2012. Seventeen countries are in this
category, with all seeing 15 percent to 17 percent annual growth and China at 25 percent.
Health care reform
State health exchanges will be emerging in 2014. We also need to respond to the guarantee issue
– spreading the risk over younger, healthier individuals to lower costs for all. Penalties rise over
time for those who do not buy health insurance, and there will be a government fine for business
that do not provide coverage.
29 ©2012 United HealthCare Services, Inc.
Source: Murray Aitken,
senior vice president for
pharmaceutical market
information company IMS
Health Inc., told the
Reuters Health Summit.
Our preferred PBM partner
In this kind of environment, you need a pharmacy benefits manager that knows the business,
has the financial backing and access to state-of-the-art technology only a Fortune 50
company can provide and has the mindset of building infrastructure around the client and
consumer.
UMR found this expertise right in the family — OptumRx. As the largest health-plan-owned
PBM, OptumRx (like UMR) can bring much more to the table than a typical stand-alone PBM.
In addition to strength and depth of skill, OptumRx offers accountability for not only pharmacy
outcomes but also the effect those decisions have on your medical benefit.
Both UMR and OptumRx are proud to be part of UnitedHealth Group. Our businesses are
organized into two arms — UnitedHealthcare, which contains the core medical businesses,
including UMR; and Optum Health Services, which is composed of the health services
businesses, including OptumRx.
This close association makes it easy to understand why OptumRx is our preferred pharmacy
benefit manager. We are tightly integrated, have access to the same committed investments
of UnitedHealth Group and present a unified approach to serving the full spectrum of our
clients’ needs.
30 ©2012 United HealthCare Services, Inc.
A full spectrum of PBM services
OptumRx is an innovative, full-service pharmacy benefit management company, managing
the prescription drug benefit of commercial, Medicare and other governmental health
plans, as well as those of employers and unions.
From claims processing to clinical services, rebate management to network management,
OptumRx takes pride in bringing excellence throughout every service we provide.
OptumRx now serves more than 13 million members, translating to approximately 21
million members due to the size of our Medicare Part D segment. Those members typically
take 2.5 times more medications than a commercial member. Last year, OptumRx
processed more than 350 million adjusted scripts, which makes us the fourth-largest PBM
in the nation.
Our business-wide generic penetration was at 74.6 percent in first quarter 2011, and mail
order generic penetration at 74.4 percent in first quarter 2011 – positioning us as one of
the industry leaders in generic utilization rates.
31 ©2012 United HealthCare Services, Inc.
By the numbers
One important key metric is our
Net Promoter Score (NPS),
which we calculate internally
every month. NPS is critical
because it measures a member’s
word-of-mouth recommendation
of a service. NPS is defined as
the percent of promoters minus
the percent of detractors while
ignoring the passives.
We use a 5-point scale from
Completely Satisfied to
Completely Dissatisfied for
the question “Would you
recommend OptumRx to a
friend or family?” Our current
Net Promoter Score is 64.6 percent.
To level set, net promoter scores for most companies are between 5 percent and 15
percent; high-performing companies such as American Express are usually around 40
percent to 45 percent.
In 2009, JD Power did an NPS analysis and based on adjusted data. We were at 66.2
percent at the time, and our Big 3 competitors were at 36 percent (ESI), 31.1 percent
(Medco) and 29.4 percent (Caremark).
According to a 2010 Satmetrix NPS analysis, comparable scores to ours list eBay at 65
percent, Facebook at 65 percent and Google at 63 percent. Apple leads the NPS space
at 78 percent.
The folks promoting us are dispersed throughout very different market segments as we
serve employers, labor unions, TPAs, PBMs and MCOs.
When clients work with both UMR and OptumRx, we receive consistently higher
customer satisfaction rates than groups without OptumRx as their PBM.
Our surveys show that when a plan has integrated benefits, we see a four-point increase
in overall satisfaction. Better accuracy, faster turnaround, members who are treated with
respect and coordinated warm call transfers drive this satisfaction.
32 ©2012 United HealthCare Services, Inc.
An integrated team
Clearly the relationship between OptumRx and UMR is
strong and connected, offering clients that integrated support as part of the
UMR team.
For instance, your OptumRx client relations manager will take care of your day-to-day
operational needs, while your OptumRx strategic account executive will ensure you are
satisfied and that we are meeting your overall strategic goals and needs.
We are grounded by strong business development and sales executive support.
Because if we are strong — you are, too.
And finally, the UMR client service coordinator and SAE are there to enrich the customer
experience even more — ensuring the health/medical plan branches are far-reaching and
intertwined with the pharmacy benefits.
In a true client partnership model, we need to define a balance between all the moving
factors to create an appropriate benefit plan for our customers. It’s a balance between
cost savings and member disruption; how can we maximize your savings with the least
amount of disruption to your membership? OptumRx has the flexibility to build a
customized pharmacy benefit plan to hit the right balance for you.
Together, we will determine which programs to implement that will address consumer
needs and maximize satisfaction, while driving value to the overall benefit strategy.
33 ©2012 United HealthCare Services, Inc.
Pricing flexibility
You have three choices of pricing:
1.
Fixed fee:
•
OptumRx passes through the ingredient cost and dispensing fee charged
by the pharmacy, without mark-up
•
The plan knows what they pay their PBM – a fixed, per-paid claim fee
•
The plan does not need to negotiate with OptumRx to receive improved
terms; the plan receives them as soon as the renegotiated pharmacy
contract takes effect
One point to consider, the pricing arrangement looks different and can be difficult to
explain and contrast with the traditional model, so it may not be the best strategy or
fit for all plans.
2. Traditional:
•
The plan receives guaranteed and predictable discounts and rebates
•
Traditional is the most widely used pricing model in the PBM industry
•
Easy to explain to clients and generally viewed as a low-risk option
•
The plan trades predictability of fixed discounts for disclosure of PBM
revenue and transparency
3. Rebate Fee Credit:
•
Reduction to UMR’s TPA administration charge, instead of rebate
payments
34 ©2012 United HealthCare Services, Inc.
The advantage of OptumRx + UMR
The long standing history between UMR and Optum Rx
strengthens us with several key differentiators, including:
•
A single financial process – The human resources manager receives one combined
feed for reporting, data and eligibility.
•
Nightly HDHP/HSA FSA auto-reimbursement feed – Information is updated in real time,
so members receive FSA information sooner.
•
Stop loss (aggregate and individual) pharmacy data integration feeds sent several
times per year – Reimbursement is sent to the customer in June or July, versus the end
of the year.
•
DM/CM/wellness data integration – Customer service can view real-time pharmacy
information with members enrolled in these programs.
•
Coordinated call center – Our integrated call centers and warm transfer technology
allows for an holistic approach to member services; the member can make one call and
manage all their medical and prescription benefit inquiries.
•
One ID card – Members have the convenience of one ID card to hold all their important
Plan ID numbers and service center information.
•
Member portal – Members need to access only one Web site to see all important medical
and pharmacy benefit information.
•
Flexible benefit design – We match the needs of the plan with a customized benefit design.
•
Client service model – Our dedicated service team partners with the UMR service team.
35 ©2012 United HealthCare Services, Inc.
What people are saying about OptumRx
Our own industry validates our value, consistently awarding us for our investments and service philosophy.
•
2010 URAC Best Practices Award in Health Care Consumer Empowerment and Protection for
its Multiple Sclerosis Disease Therapy Management Program – One of only two platinum awards
(and the only one given to a PBM) for our innovative member outreach program that improves
outcomes and reduces costs. Additionally, we are the first PBM to earn all four URAC Pharmacy
Quality ManagementSM accreditations.
•
2011 LearningElite Award – This is similar to the ASTD BEST award. We won a 2009 ASTD BEST
Award from the American Society for Training and Development (ASTD) for our Customer Advocacy
initiative, becoming the first PBM to be so honored. The initiative features innovative, interactive
curriculum with hands-on activities, role playing and simulations.
•
Top 1 percent of companies nationally and highest among peers in 2010 JD Power Customer
Call Center satisfaction survey – We showed best-in-class among all 12 mail pharmacy call
centers with an overall score of 870. OptumRx received the highest rankings for customer service
and cost competitiveness factors among mail order pharmacies in the J.D. Power and Associates
2009 National Pharmacy Study. We ranked second overall among mail order pharmacies, and were
one of only two mail order pharmacies to receive all five Power Circles, which equates to “among the
best” for the overall experience.
•
Third consecutive TIPPSSM Re-Certification for Pharmacy Benefits Transparency Standards
– We received re-certification for Transparency in Pharmaceutical Purchasing Solutions (TIPPS)
from the HR Policy Association Pharmaceutical Coalition, earning the coalition’s highest level of
transparency by providing actual average inventory cost for mail order drugs. Certification is
bestowed only upon PBMs that are willing to meet the Coalition’s rigorous transparency standards
and agree to provide Coalition members with audit rights to validate compliance.
We received the prestigious Verified Internet Pharmacy Practice Sites™ (VIPPS®) reaccreditation by the
National Association of Boards of Pharmacy® (NABP®) for web- based pharmacies in Carlsbad and OPS.
We won Gold for Best eBusiness Site from the eHealthcare Leadership Awards in 2010 and a 2009 Gold
MarComm award for
writing/Web copy. Plus
the WilsonRx Survey
placed us as the top mail
service pharmacy two
years running, rating us
No. 1 nationally in overall
member satisfaction for
two years in a row.
36 ©2012 United HealthCare Services, Inc.
Tightly integrated internal solutions:
Stop loss
UMR has strong relationships with the nation’s leading stop loss carriers. Our preferred status
earns customers premium discounts. Just as importantly, customers experience fewer handoffs
and encounter fewer of the complications that can occur when you use more than one vendor.
By using our arrangements, customers can work with financially stable carriers who are committed
to the stop loss market. Our customers receive preferred pricing because of UMR’s ability to
provide access to the UnitedHealthcare networks and our proven cost containment programs.
Customers have access to plan mirroring provisions, avoiding coverage gaps between their
medical plan documents and stop loss policies.
Our claim turn-around guarantees are the best in the industry. Our customers are able to have
carriers lock in rates sooner than the industry average, which allows them access to unique
programs, such as three-year contracts, Raising the Bar and Contract Advantage Plan (CAP).
CAP is a policy endorsement offered by HCC Life. It guarantees that if the customer renews, the
renewal policy will not contain any additional covered persons with a separate individual-specific
deductible (i.e. laser). Specific monthly premium rates on the renewal are guaranteed not to
increase by more than 12 percent over the current rates. The group must purchase CAP upfront;
it is available for additional premium.
The UMR advantage gives customers integrated and
immediate claim notification, so you can get a
jumpstart on managing high-cost claims.
Our support features include weekly claim filing of new and
subsequent claims, electronic claim filing and select carrier
system integration and low document filing requirements.
Our support also includes an industry-leading Stop Loss
Activity Monitoring (SLAM) notification and trigger reporting
that includes online and drill-down with daily updates.
UMR gives direct carrier access to in-house care management
resources for prognosis updating. We send final plan documents
and amendments to carriers for you.
37 ©2012 United HealthCare Services, Inc.
MyStopLossCenter.com
To stay on top of your stop loss activity, just click on
the myStopLossCenter tab at www.umr.com. You’ll gain
immediate access to current and prior year stop loss activity, as well as aggregate and
specific stop loss reports.
myStopLossCenter allows you to view specific stop loss claims. With stop loss claim
inquiry you can see:
•
•
•
•
•
•
•
•
Employee and claimant name
Policy number
Claim type
Carrier
Contract type
Requested, denied and received amounts
Dates requested and received
Stop loss deductible
And, UMR’s automated e-mail notification will keep you informed of any activity for
your account.
38 ©2012 United HealthCare Services, Inc.
Tightly integrated internal solutions:
Reporting
UMR offers more than the UnitedHealthcare network advantage. With capital investment, we
are also able offer state-of-the-art reporting capabilities so you can measure just how effective
your plan is and where your money is going. With UMR’s customized, on-demand reporting,
you can leverage industry and national benchmarks to measure your plan’s trend.
UMR will provide you with in-depth plan analysis and recommendations to support continuous
improvement and strategic decisions. We offer predictive technologies to support targeted,
proactive health and wellness programs. And, our online resources are available 24/7, so you
can access reports at your convenience.
UMR offers integrated and detailed reporting through
several tools.
Our online reporting tool—InfoPort—provides daily, weekly, monthly or quarterly reports,
according to your preference.
Thomson Reuters Advantage Suite© (formerly known as MedStat) is a Web-based analysis
tool for medical, pharmacy (if available) and enrollment data. You have access to extended
data analytics with slicer/drill capabilities and extended benchmark information. This tool
offers 32 reports with exploring capabilities and is easy to export. It offers condition and Major
Diagnostic Category information and provides rolling 24-month data, paid and/or limited
incurred. Benchmark data (called MarketScan®) is based on 31.5 million lives.
Finally, our data services provide claim extract setup or FTP-Internet file transfers. We
support one-time ad hoc reports, data requests and production reporting.
Additional UMR custom support is available for:
•
ASA-certified reserve/
IBNR estimates
•
Customized benchmarking
•
Ad hoc reporting
•
Stewardship analysis
reports
•
Predictive modeling
•
Episode cost/quality
profiling
•
Care management reporting
(if using UMR’s internal solution)
39 ©2012 United HealthCare Services, Inc.
InfoPortSM – online reporting tool
InfoPort allows you to not only monitor plan performance but identify trends and outliers
through analyses of three or more years of UMR data.
You can access information on claims, benefit utilization, financial activities, network
performance and enrollment. Transactional data is updated daily, with only a twobusiness-day lag.
InfoPort allows you to drill down by group, benefit level, benefit plan, class, coverage tier,
location, member ID, patient relationship and more. We have report designs with multiple
report layouts, and you can customize report criteria, allowing you a myriad of reporting
options. Even better, you can save your own customized templates.
You can run reports on incurred and paid timeframes. And, you can create, run and view
your reports on demand. You can also schedule recurring reports with dynamic dates.
Report data is available in PHI and non-PHI versions. Also, you can easily export your
reports to multiple formats, such as Excel, PDF, and Word.
Available reports include:
•
Census: enrollment; summary
•
Extracts: claim level, claim service level, enrollment census
•
Claim: detail, lag, summary, summary by member/network/provider,
summary service level
40 ©2012 United HealthCare Services, Inc.
Advantage Suite® – online reporting tool
For an analytical overview of claims, UMR offers Advantage Suite®, an online reporting
tool created and maintained by Thomson Reuters.
While not a financial tool for reconciliation, Advantage Suite (formerly called Medstat) can
help you analyze health care costs, utilization, quality and performance trends and
measures. You can drill down to product line/plan, region, metropolitan statistical area,
employee status, relationship, location and coverage tier. You can compare your costs
and utilization to robust geographical and industry benchmarks.
Advantage Suite, which is updated monthly, shows gross claims. It does not include stop
loss information or administration fees. Reports are run based on paid dates or incurred
dates, and standard reports can be modified to conduct ad hoc analyses.
You can see trends in medical and Rx data, compare
against benchmarks, track preventive and chronic
conditions and identify cost drivers.
41 ©2012 United HealthCare Services, Inc.
Tightly integrated internal solutions:
Online services
UMR’s Web portal gives you one online source for all your benefits needs. There’s no need to
remember multiple user names and passwords, because you don’t need multiple accounts.
Such easy access to all UMR products encourages members
to actively participate in all aspects of their health plans.
Members can look up:
•
•
•
•
•
Medical claims and benefits
Dental claims and benefits
Flexible spending account
information
Pharmacy claims through
single sign-on
access to OptumRx
Care management information
Employers and brokers can find
information on:
•
•
•
Medical claims and benefits
Dental claims and benefits
Flexible spending accounts
They can also access:
•
•
•
•
OptumRx reports
Stop loss claims and reports
Subrogation reports
Enrollment
UMR is not reliant on third-party development or canned solutions for our Web capabilities. We
develop our solutions in house, so we can be as flexible as you need us to be and respond faster
to your needs.
To find information about our products and how we do business, visit www.umr.com. That’s
where members, employers, providers, client advisors and partners go to access a wealth of
services. Information is kept confidential and secure. Users must register and log into the portals,
allowing us to verify their identities.
We also want you and your plan members to easily navigate the site. Any problems or lag time
can be resolved through a toll-free phone call.
42 ©2012 United HealthCare Services, Inc.
Features for employers
These features are all just a click away:
For a demo of the Employer Information Center:
•
Logon to www.umr.com
•
Select “employers”
•
Enter group number: 76888888
•
When prompted for username and password, use:
Username: demoemployer
Password: secret1
•
To search for employee information, use Member ID: 088000001
•
For Check Register, use dates 10/01/2002 – current date
43 ©2012 United HealthCare Services, Inc.
Features for members
For a demo of the Member Information Center:
•
Logon to www.umr.com
•
Select “members”
•
Enter member ID: 088000001
•
When prompted for username and password, use:
Username: demoemployee
Password: secret1
44 ©2012 United HealthCare Services, Inc.
Our value to you
In summary and to repeat, UMR offers you an advantage
no one else in the industry can offer.
We are the only third-party administrator who can give you the significant network
discounts of UnitedHealthcare.
We are the only TPA that can give you a totally integrated approach to benefits
administration or easily plug and play with your preferred vendors.
We are the only TPA that can easily respond to health care mandates, regulations and
market changes.
We call it the UMR Advantage — the flexibility and service you expect from a stellar TPA
with the scale and reach of a Fortune 50 company.
45 ©2012 United HealthCare Services, Inc.
UM0872 06-12