myhealthcare Cost Estimator (myhce)
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1 myhealthcare Cost Estimator (myhce)
2 myhealthcare Cost Estimator By the Numbers 99.5% of our consumers Have access to personalized estimates 635+ / 365+ Unique services / treatments covered $2.8 Billion In cost estimates generated 900,000 consumer sessions In 2013 #1 Ranking By Pacific Business Group on Health $0 Complementary to customers ** Health4Me Mobile App Now Available to Everyone** Broad access and services Unsurpassed precision Integrated quality Comprehensive support 2 Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
3 Portland Oregon Knee MRI Example 3 Proprietary information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
4 myhce services covered 635+ unique services and 365+ care paths Physician Office Visits (various specialties), Chiropractic (various services), Electrocardiogram (various), Echocardiography (various), Ear Infection, Acute Bronchitis, High Blood Pressure, etc. COMING SOON! Preventive Radiology Laboratory Outpatient Inpatient Cancer Preventive Office Visits (various specialties), Screening Mammogram, Screening Colonoscopy, etc. X-ray, MRI (knee, lumbar spine, brain), CT Scan (abdomen, chest, pelvis, head/brain), Ultrasound (various), etc. Glucose, Hemoglobin, Urinalysis, Vitamin D, Lipid Panel, TSH, CBC, etc. Diagnostic Colonoscopy, Endoscopy, Knee Arthroscopy, Tonsil Removal, Ear Tubes, Hernia Surgery, Vasectomy, Carpal Tunnel, etc. Total Hip Replacement, Total Knee Replacement, Childbirth, Hysterectomy, Cervical Spine Fusion, Back Surgeries, etc. Cervical, Skin, Breast, Colon, Esophagus Behavioral Broken Arm Broken Leg Bunions Circumcision Allergy Testing Deviated Septum Additional Office Visits Women s Health Additional Surgeries, etc. 4 Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
5 Future roadmap Advance the core capability Integrate the consumer experience Expand reach and relevance Expand scope to ~500 care paths / ~900 services, including broken bones, additional women s health and frequently searched surgeries Introduce additional, relevant provider quality data Design enhancements for even simpler navigation Integration with complementary digital capabilities for easy experience Prescription, ancillary service estimates Provider & symptom search Benefits selection Claims status, on-line bill payment Appointment scheduling Personalized consumer messaging and reminders: savings opportunities, health management and improvement, etc. Consumer engagement scorecards Further integrate into our consumer s personalized service experience Advocate4Me Facilitate end-to-end health care engagement myclaims Manager 5 Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
6 UNITEDHEALTH PREMIUM DESIGNATION PROGRAM Power to transform heath care delivery
7 UnitedHealth Premium physician designation PROMOTING VALUE: QUALITY FOR A GIVEN COST Quality and cost transparency Longest running physician quality and cost efficiency designation program (2005) National industry, evidence-based and specialty society standards Evaluate doctors on more than 75 conditions and 300 measures Physicians who fail to meet quality not eligible for cost efficiency Access Broad application Recognition 148 markets and 25 specialties evaluated* Accounts for more than 80% of all medical costs* Includes primary care physicians and specialists Available to members at no additional cost Integrated into customer service, clinical and online experiences Benefit designs based on Premium designation Received the National Committee for Quality Assurance (NCQA) program Physician Quality (PQ) certification and meets the Consumer Purchaser Disclosure Project s Patient Charter standards *Data as of First Quarter Proprietary information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
8 Impact on quality and overall cost COMPARISON OF SURGEONS WHO MET QUALITY CRITERIA VERSUS OTHER SURGEONS Care variation Stent placement Quality designated cardiologists had: 19% lower average complication rates and 46% fewer average redo procedures Cost variation Orthopedics 22% Lower costs for Quality & Cost Efficiency designated Orthopedic specialists compared to other Orthopedic specialists. 17% Average savings per episode for all designated specialties Average savings of 3-6% of total medical spend 8 Proprietary information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Treatment Category Inpatient Treatment Categories DRG (MS DRG) ICD9 [Hip & Knee Only]
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NCCT List of Procedures Treatment Category Inpatient Treatment Categories DRG (MS DRG) ICD9 [Hip & Knee Only] Bariatric Surgery - Laparoscopic Gastric Bypass DRG - 288 MS DRG - 621 Cardiac Angioplasty
2016 Mayo Clinic Health System Eau Claire Charge and Reimbursement Information for Health Care Consumers Required by 2009 Wisconsin Act 146
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