Health management program

Transcription

1 Health management program To help improve the health of older individuals with chronic medical conditions, UnitedHealth Group and AARP Services Inc. launched a health management pilot program in early December The pilot program -- which launched in New York City, Los Angeles, central North Carolina, Cleveland and Tampa, Fla. provides support, education and health management tools for members and their caregivers. The program works in collaboration with the members primary physicians. At program launch, members, caregivers and physicians received informational mailings. See below to review sample letters from this new health management program! Copyright 2006 United HealthCare Services, Inc.

2 [PATIENT FIRST NAME] [PATIENT LAST NAME] [PATIENT STREET ADDRESS] [PATIENT CITY], [PATIENT STATE] [PATIENT ZIP] [DATE] Dear [PATIENT FIRST NAME] [PATIENT LAST NAME]: Thank you for taking time to speak with me about your health and well-being. Welcome to the health management program, available to you at no additional cost. You are eligible for this program because you are insured by the AARP Medicare Supplement Insurance plan, underwritten by United HealthCare Insurance Company. Reaching your health goals. My role as a registered nurse with the program is to help you with your health care on a daily basis. I will be available to help with needs when you are at home and in between doctor visits. As you think about your health goals, I can help you: Work with your doctor Find quality health care providers who accept Medicare coverage Understand your medications and how you might save money on them Locate community services Many people with health concerns feel stressed or down. Sadness or depression can often occur. I ve enclosed a brochure that explains what depression is, how it can affect your body and how it can be treated. Look inside for your copy of: The Mind-Body Connection: How Depression Can Worsen Your Medical Condition. How to get the most out of this program. Make sure you sign and return the enclosed health management consent form. Please mail the form to: [REQUESTOR FIRST NAME] [REQUESTOR LAST NAME] 3803 North Elm Street Greensboro, NC The signed form indicates your permission for me to provide the services listed above. If you have questions on the form, please call me at the number below. Your privacy and security is protected.

3 To reach me, call [REQUESTOR PHONE NUMBER], extension [REQUESTOR EXTENSION], Monday through Friday between 8 a.m. and 5 p.m. [REQUESTOR TIME ZONE]. If I can t take your call personally, or you can t call during business hours, please leave me a message. Please let me know the best day and time to reach you, and include your area code with your phone number. Remember, you can find health information any time at Or, you can call Nurse HealthLine SM by OptumHealth SM. Simply call to talk to a nurse 24 hours a day, seven days a week. I am glad you joined our program. I look forward to working with you, and making a difference. Sincerely, [REQUESTOR FIRST NAME] [REQUESTOR LAST NAME], [REQUESTOR TITLE] UnitedHealthcare DMCM002 Medicare Supplement coverage insured by United HealthCare Insurance Company (for New York residents, United HealthCare Insurance Company of New York). UnitedHealthcare provides information and support to our insured members. It is not a substitute for a doctor s care. Personal health information is kept private in accordance with our privacy policy. For more information, please refer to the telephone number on your health insurance identification card. AARP Health is a collection of health related products, services and insurance programs available to AARP members. Neither AARP nor its affiliate is the insurer. AARP contracts with insurers to make coverage available to AARP members. OptumHealth SM is the provider of Nurse HealthLine SM. OptumHealth nurses cannot diagnose problems or recommend specific treatment and are not a substitute for your doctor s care. These services are not an insurance program and may be discontinued at any time. All decisions about medications, vision care, and health and wellness care are between you and your health care provider. PL /090108

4 Health Management Program Participation Consent Form Patient Name (please print) Patient s Member ID Number (from your insurance card) Street Address City/State/ZIP Code Telephone Number Nurse Name (from cover letter) Best time to reach you I and/or my designated representative (Power of Attorney or legal guardian) consent to participate in the health management program (only one signature is needed). This consent form is valid for one year or for the time of my health insurance policy coverage, whichever is less. Patient Signature Date Guardian/Power of Attorney Signature Date Please send this completed form to this address: Health Management Program 3803 North Elm Street Greensboro, NC PL

5 Health Management Rights and Responsibilities We are committed to delivering health management services that provide you with information and support to help you take an active role in your health. We believe that you, as a participant in the health management program, have the right to: Be treated with respect and dignity Self-determination, including involvement in developing your care plan Privacy and confidentiality in accordance with applicable privacy laws A fair and complete assessment of your health Receive, upon request, information and resources regarding the Americans with Disabilities Act, and information and resources for your questions regarding such subjects as power of attorney for health care issues Know all options concerning your care plan, and to be an important part of the decisionmaking process Understand information about your health care. If you speak a language other than English, or if you have a physical or mental disability, support will be provided so that you can make informed health care decisions. Information regarding the health management relationship, including the relationship with your insurance payer and how information is shared with your insurance plan and other third parties A description of the rationale used to select you for health management services Receive both verbal and written information regarding health management services and recommendations Refuse any portion of your care plan, including health management services, and be given the implications relating to benefits and health outcomes Receive information regarding case closure criteria Withdraw from the process at any time Know the process to follow in the event that you feel your rights have been violated, or you have been treated improperly A nurse will inform you of your choices and will ask for your input into your management plan. If you would like to submit a complaint, please call your health management program nurse and ask to speak with the health management program supervisor. PL

6 Advanced Care Planning: Important Information An Advance Directive is a legal document that includes a Living Will or a Medical Power of Attorney. It directs your care if you re unable to do so or you can t communicate your decisions because of unexpected or prolonged illness or injury. Since these events can occur unexpectedly, it makes sense to have instructions for your family and doctors before a crisis occurs. Having an Advance Directive provides you with the peace of mind that you will get the care you value. It also will reduce stress and anxiety for your family. Of course, the hope is that you ll never need to use it, but it is very good to have just in case. If you want more information, there are resources available to you. One of them is the national organization Caring Connections, a program of the National Hospice and Palliative Care Organization. Visit their Web site at for more information and forms. Residents of North Carolina, New York, Florida and California can find information on a type of advance directive called Five Wishes. It is available at For Ohio residents, please visit for more information. A nurse can answer any questions you have about your choices, and can add the information about your decisions to your health management plan. If you need help understanding this document, please ask your nurse or call , ext You do not need to fill out this form to participate in the program. This is not an endorsement of any commercial products, services or information presented in any Web sites, other than our own. The information contained in the Web site(s) referred to is general in nature and is intended to be used as an educational resource only. It is not intended to address every aspect of a clinical situation or to serve as a substitute for professional health care, advice or treatment. We do not guarantee the accuracy of any third-party information presented in any of the Web sites. Reliance upon the information is at your sole risk. If you have specific health care needs or questions regarding your health and medication related treatment, you should contact an appropriate health care professional. PL

7 Medicare Supplement Insurance insured by United HealthCare Insurance Company PL Want to make the most of your health? Look inside to find out more.

8 You can take charge of your life and health. We can help. If you ve been diagnosed with chronic health conditions, you can participate in the health management program. This program which is available at no additional cost to you gives you access to a registered nurse who can help you: Learn to take charge of your health and emotional well-being through information and support. Understand what medications are important for your condition and how you may be able to save money on them. Locate doctors and hospitals recognized for delivering quality care. Work with your doctor by offering tools and resources to share during your visits. Join the health management program today. Let us help you live your life to the fullest! Call , ext (TTY: 711). We re available to take your call Monday through Friday, 8 a.m. to 5 p.m. in your local time zone. Para hablar con un miembro del personal de enfermería sobre su condición de salud, favor de llamar al , ext (TTY: 711) entre las 8 a.m. y 5 p.m. durante el huso horario local. We know that life gets busy at times. So, we ll call you in the next few weeks if we don t hear from you. Enroll today! 2008 IR_xxxxxxxxxx Medicare Supplement Insurance insured by United HealthCare Insurance Company AARP Health is a collection of health related products, services and insurance programs available to AARP members. Neither AARP nor its affiliate is the insurer. AARP contracts with insurers to make coverage available to AARP members. Medicare Supplement coverage insured by United HealthCare Insurance Company (for New York residents, United HealthCare Insurance Company of New York). UnitedHealthcare provides information and support to our insured members. It is not a substitute for a doctor s care. Personal health information is kept private in accordance with our privacy policy. For more information, please refer to the telephone number on the health insurance identification card.

9 United HealthCare 3803 North Elm Street Greensboro, NC [DATE] Dr. [PHYSICIAN FIRST NAME] [PHYSICIAN LAST NAME] [PHYSICIAN ADDRESS 1] [PHYSICIAN CITY], [PHYSICIAN STATE] [PHYSICIAN ZIP] Dear Dr. [PHYSICIAN FIRST NAME] [PHYSICIAN LAST NAME]: We are pleased to announce a new health management program, designed to help: Make sure your elderly patients understand their conditions and how to deal with them effectively Identify and address financial issues that may be a barrier to medication adherence Resolve transportation issues which cause missed appointments Find the right community resources to help these patients Provide support and guidance between office visits This program and the services available through it are for your patients enrolled in an AARP Medicare Supplement plan, insured by United Healthcare Insurance Company. We are inviting you to team with us as we launch the health management program, and it is our hope that you will recommend the program to your patients who are eligible. A program designed with your patient and your staff in mind. The program is designed to help patients and their families coping with chronic conditions and complex medications. Additionally, it will save time for you and your office staff. We support you and the treatment plan you develop for your patient by: Reinforcing your plan of care and instructions Offering services and support that will make it easier for your patient to manage their health conditions and follow your guidance Our goal is to offer resources and tools to you and your patients without creating a burden. The program is not intended to diagnose or treat, and it is not a substitute for your professional medical advice. A collaborative approach supports your treatment plan. Through the program, there will be ongoing contact between our clinical staff and your office. A nurse case manager works directly with your patient, supporting your treatment plan, providing education and coordinating services We may occasionally request information via fax or send you patient-specific information In collaboration with you and your patient, a plan of care will be established, specific to your patient s needs The plan of care will address areas such as: Medication compliance or other medication-related issues Screening for depression and monitoring symptoms as appropriate Understanding the importance of routine lab work and what the results indicate Setting goals and working toward a healthful lifestyle Evaluating support systems and mental well-being

10 Overall, this program will save you time spent explaining information multiple times, or reactively administering treatments when directions are not followed correctly, or lost on missed appointments. And, your patient will receive enhanced support and education. We are interested in hearing your suggestions and/or comments and are especially interested in what services/support would make it easier for you and your staff to treat this population. Health and well-being resources available to you and your patients. If you have any questions or need more information about the program, please call us! We welcome suggestions and comments from you or your staff. Call toll-free at , Monday through Friday between 8 a.m. and 5 p.m. Provider online portal: including clinical information and helpful tools relevant for your elderly patients and their caregivers PsychInfo Line for behavioral health consultations: Patient access to a nurse, 24 hours a day, seven days a week, via Nurse HealthLine SM by OptumHealth SM : We recognize the challenge associated with meeting the health care needs of the growing aging population and would love to be able to partner with you, your office staff and eligible patients to make things a little easier for everyone. Sincerely, Paul Solomon, M.D. National Medical Director United HealthCare Medicare Supplement coverage insured by United HealthCare Insurance Company (for New York residents, United HealthCare Insurance Company of New York). United HealthCare provides information and support to our insured members. It is not a substitute for a doctor s care. Personal health information is kept private in accordance with our privacy policy. For more information, please refer to the telephone number on the health insurance identification card. AARP Health is a collection of health related products, services and insurance programs available to AARP members. Neither AARP nor its affiliate is the insurer. AARP contracts with insurers to make coverage available to AARP members. Optum is the provider of Nurse HealthLine SM. Optum nurses cannot diagnose problems or recommend specific treatment and are not a substitute for your doctor's care. All decisions about health and wellness care are between you and your health care provider. This is not an insurance program and may be discontinued at any time.

11 United HealthCare Insurance Company 3803 North Elm Street Greensboro, NC [DATE] Dr. [PHYSICIAN FIRST NAME] [PHYSICIAN LAST NAME] [PHYSICIAN ADDRESS 1] [PHYSICIAN CITY], [PHYSICIAN STATE] [PHYSICIAN ZIP] Dear Dr. [PHYSICIAN FIRST NAME] [PHYSICIAN LAST NAME]: Announcing a new health management program. We are pleased to announce the health management program. The health management program is available to your patient [PATIENT FIRST NAME] [PATIENT LAST NAME], DOB [00/00/0000], who is enrolled in an AARP Medicare Supplement plan, insured by United HealthCare Insurance Company. The program is designed to support you and the treatment plan you developed for your patient saving you time by reinforcing your instructions and offering your patient support in managing their health conditions. It is not intended to diagnose or treat, and it is not a substitute for your professional medical advice. We hope you agree that there is value working together with your patient. We believe the program will make it easier for you, your patient, and your office to manage the complexities involved in coordinating care. How the health management program works. A nurse will work directly with your patient between office appointments to support your treatment plan, provide education and coordinate services. In collaboration with you and your patient, a plan of care will be established, specific to your patient s needs, which will address areas such as: Medication compliance or other medication-related issues Screening for depression and monitoring symptoms as appropriate Understanding the importance of routine lab work and what the results indicate Setting goals and working toward a healthful lifestyle Evaluating support systems and mental well-being If you have any questions or need more information about the program, please call us! Call toll-free at , choose option 1, ext You can rest assured that all information shared during the call will be protected in accordance with the privacy policy of your patient s plan. You also have these additional resources available to you as part of this program: Provider online portal: PsychInfo Line for behavioral health consultations:

12 We would greatly appreciate your support in joining in this transformative pilot program. We are testing the effectiveness in a few markets--please team with us in this innovation! Sincerely, Paul Solomon, M.D. National Medical Director UnitedHealthcare Medicare Supplement coverage insured by United HealthCare Insurance Company (for New York residents, United HealthCare Insurance Company of New York). UnitedHealthcare provides information and support to our insured members. It is not a substitute for a doctor s care. Personal health information is kept private in accordance with our privacy policy. For more information, please refer to the telephone number on your patient s health insurance identification card. AARP Health is a collection of health related products, services and insurance programs available to AARP members. Neither AARP nor its affiliate is the insurer. AARP contracts with insurers to make coverage available to AARP members. PL