Improving wellness and health outcomes in Massachusetts

UnitedHealthcare Community Plan of Massachusetts has a history of quality standards for our SCO members. We use HEDIS, Stars and CAHPS results to identify where quality issues exist and use data analysis and risk stratification to improve performance.

All members have a care manager that ensures appropriate care and services are in place. About 50% of members are offered a yearly in-home clinical HouseCalls visit at no cost, which is an opportunity for a nurse to go over a member’s health history, conduct a physical and identify any health concerns that may need extra monitoring.

Additionally, members have been able to receive in-home testing kits to screen for colorectal cancer and to conduct diabetic blood sugar testing. The need for increased in-home testing is something that has only been amplified during the COVID-19 pandemic, where accessing care at home is the safest and most convenient option.

During a time where health services via telehealth has been successful and vital to providing continuous care to our members, we’ve also ensured that we’re meeting the needs of our diverse population. All members were mailed a 15-page brochure with information on how to access services during the pandemic, including how to prep for visits, telehealth options and general wellness tips. We developed and translated a member Care Checklist and a Flu Reminder postcard in 12 languages, translated materials for a Colorectal Cancer Screening test kit in 11 languages, as well as a Diabetes blood sugar test kit and Diabetes urine test kit for kidney function in three languages.

In 2019, we documented flu outreach to nearly 100% of members, reminding them about the importance of getting a flu shot. This resulted in more than 75% of our members getting a flu shot.

All that we do is member focused. We collect members’ opinions regularly to uncover areas for improvement. Some of those areas include improving nutritional knowledge, hypertension management and mental wellness. In February 2020, a Health Equity workgroup was established to address matters of inequity that are negatively impacting our members’ health and wellbeing.

UnitedHealthcare uses client data and existing market knowledge to identify where health disparities exist and to introduce interventions to reduce these disparities. Our members consistently provide high ratings of either meeting or exceeding 4 stars regarding their experiences for many categories including: diabetes management, cancer screening, getting prescription drugs and physical health.

We remain committed to working toward improving health outcomes, reducing health disparities and delivering top value to taxpayers by providing best-in-class quality for the members and communities we serve.

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