UnitedHealthcare Achieves Full NCQA Accreditation Across its Principal Commercial Health Plan Offerings

  • UnitedHealthcare recognized for providing access to quality care and services for its customers
  • Is one of only two national insurers to receive additional certification for physician and hospital quality programs

UnitedHealthcare, a UnitedHealth Group (NYSE: UNH) company, has achieved full National Committee for Quality Assurance (NCQA) Accreditation across its principal commercial health plan offerings.

The latest accreditations mean all of UnitedHealthcare’s eligible fully insured and self-funded commercial HMO, POS and PPO plans have received NCQA accreditation.

“Accreditations reflect a health plan’s ability to work with physicians to improve the quality of clinical care to enhance customer service. We applaud UnitedHealthcare for its efforts in collaborating with the medical community and its health plan participants to deliver great service and great care,” said Margaret E. O’Kane, president of NCQA.

Sam Ho, M.D., UnitedHealthcare executive vice president and chief medical officer, said: “NCQA’s accreditation process provides an independent review of our programs. This review helps assure our customers that the information, programs and services that we offer give them access to quality health care and provide opportunities for them to enhance their own well-being so they may live healthier lives.”

NCQA Health Plan Accreditation is a nationally recognized evaluation that employers, regulators and consumers can use to assess health plans. The accreditation process evaluates all parts of a health plan’s delivery system, from physicians and hospitals to other health care providers and administrative services. The review also includes onsite and offsite evaluations by a team of physicians and managed-care experts.

UnitedHealthcare’s NCQA Health Plan Accreditation performance results, available at www.ncqa.org, were reported in five categories. Following are examples of how UnitedHealthcare health plans satisfied each NCQA category’s requirements:

  • Access and Service – UnitedHealthcare offers a broad national network of health care providers with more than 600,000 physicians and care professionals and 5,000 hospitals.
  • Qualified Providers – Building on more than a decade of assessing physician and hospital performance, UnitedHealthcare analyzes physician practices based on established and accepted clinical guidelines for quality care. UnitedHealthcare’s Premium® physician designation program enables plan participants to compare quality and cost-efficiency information for physicians and health care facilities.
  • Staying Healthy – UnitedHealthcare provides a range of tools, such as delivering personalized messaging to remind them of key health milestones and alerting physicians and plan participants about services individual patients may have missed, to help plan participants maintain good health and enhance their early detection of potential health issues.
  • Getting Better – UnitedHealthcare provides a number of resources to help people recover from illnesses, including inpatient care management programs, and disease management and Nurse Line programs.
  • Living with Illness – UnitedHealthcare provides programs focused on preventing complications in patients with chronic diseases using the most current technology, such as synchronizing data from various care providers and connecting patients to programs that help them manage their chronic conditions. Physicians are provided with updates to help monitor their patients’ chronic conditions.

UnitedHealthcare also received NCQA’s PQ (physician quality) and HQ (hospital quality) certifications for focusing on sound methodology and transparency, and for providing information on the cost and quality of care. UnitedHealthcare is one of only two national health insurers in the country to attain PQ and HQ certification, which is received following an extensive review of its physician and hospital initiatives.

“Our goal is to ensure that all of our health plans continue to meet the high standards of customer engagement and satisfaction,” said Dr. Ho. “In addition, we will continue to engage in physician and hospital quality initiatives that are transparent and sound, while focusing on both quality and cost.”

For more information about NCQA please visit at www.ncqa.org.

About UnitedHealthcare
UnitedHealthcare (www.unitedhealthcare.com) provides a full spectrum of consumer-oriented health benefit plans and services. The company organizes access to quality, affordable health care services on behalf of approximately 25 million individual consumers, contracting directly with more than 600,000 physicians and care professionals and 5,000 hospitals nationwide to offer them broad, convenient access to services nationwide. UnitedHealthcare is one of the businesses of UnitedHealth Group (NYSE: UNH), a diversified Fortune 50 health and well-being company.