Rhode Island Whole-Person Care Management

Our clinical management programs serve to optimize the health and well-being of members with chronic illness or who are at high risk for adverse medical outcomes. To accomplish this, we developed a member-focused, integrated complex clinical management model that facilitates collaboration between our members and their health care teams. These initiatives focus on improving member self-management skills, active decision-making and participation in health care interventions personalized to their risk profile and conditions. Additionally, we build upon our community-based, collaborative relationships to extend our reach in local communities where health disparities exist and can be improved. Targeted outreach initiatives assist members to achieve the following:

  • Improve health outcomes and quality of life
  • Support healthy lifestyles through targeted condition education and preventive health initiatives
  • Manage chronic health conditions and other targeted health conditions
  • Provide opportunities for member access to health education programs through community partnerships

The purpose of the Whole-Person Care (WPC) Management program is to facilitate appropriate health care services across the continuum of care, as well as to monitor and evaluate options and services to meet an individual’s needs to promote quality, cost effective outcomes. WPC Management targets individuals who have a higher persistency of health care utilization with complex care needs and who have chronic and complex risk factors. The program’s structure and functionality support the UnitedHealthcare Community & State commitment to ensure compliance with care management standards as set forth by state and federal regulatory agencies and accreditation organizations.

 

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