UnitedHealthcare, North Shore-LIJ Health System to Offer New Tiered Benefit Plan Options Based on Accountable Care Concepts

October 23, 2012
  • New plan options available to employers in Nassau, Suffolk and Queens counties for fall enrollment
  • North Shore-LIJ physicians in primary network for benefits plan

UnitedHealthcare today introduced a new suite of tiered health benefit plans that include accountable care concepts built around physicians and hospitals affiliated with the North Shore-LIJ Health System. UnitedHealthcare will begin offering the health plans to Nassau, Suffolk and Queens county employers for Jan. 1, 2013, enrollment.

The new health plan suite, called UnitedHealthcare North Shore-LIJ Advantage Plans, is part of UnitedHealthcare’s ongoing emphasis on increased collaboration, outcome-based payment and new benefit designs that are transforming how health care is paid for and delivered.

“UnitedHealthcare and North Shore-LIJ are working together to improve the local delivery of care and lower costs for our customers,” said Bill Golden, CEO, UnitedHealthcare Employer & Individual of New York. “Thanks to North Shore-LIJ’s leadership and willingness to innovate with us, new benefit designs like the Advantage Plans will help enhance the quality and cost efficiency of care provided through a focused, easy-to-access provider network.”

As part of the collaboration with UnitedHealthcare, the North Shore-LIJ Health System has the opportunity to earn financial incentives based on quality health outcomes and medical cost reductions in both office and hospital settings among fully insured individuals enrolled in the UnitedHealthcare North Shore-LIJ Advantage plans. North Shore-LIJ offers 16 hospitals, more than 9,000 affiliated physicians, and a vast network of long-term care facilities, rehabilitation, home care and other outpatient services.

“As New York’s largest integrated health system, North Shore-LIJ has a long track record of providing a full continuum of high-quality, evidence-based care to hundreds of thousands of patients throughout the metropolitan area,” said Michael Dowling, president and CEO, North Shore-LIJ Health System. “We look forward to working with UnitedHealthcare to improve the health of the 7 million people who live in the communities we both serve, while also reducing health care costs and improving patient satisfaction.”

The UnitedHealthcare North Shore-LIJ Advantage Plans have several different plan options that include two in-network benefit tiers. Tier 1 is a subset of the UnitedHealthcare Choice network that includes several thousand physicians and other select care providers affiliated with the North Shore-LIJ Health System. Tier 1 features lower premiums and out-of-pocket costs for plan participants who seek care from these providers. Tier 2 comprises all other physicians and health care providers in the UnitedHealthcare Choice network. Tier 1 plan customers may seek in-network care from health care providers in Tier 2, but with slightly higher out-of-pocket costs.

“Health benefits plans like UnitedHealthcare North Shore-LIJ Advantage reward people who get care from high-quality providers, while rewarding doctors and hospitals for helping to improve the quality of care,” said Keith Zuckerman, president of Hauppauge-based Professional Group Plans Inc. “These plan designs, supported by hospital and physician contracts with accountable care components, help provide the necessary tools and incentives to ensure the health care system works the way it is supposed to – delivering quality care while better managing costs.”

UnitedHealthcare, a UnitedHealth Group (NYSE: UNH) company, serves nearly 4 million New York residents with a care provider network of more than 230 hospitals and more than 40,000 physicians statewide.

About North Shore-LIJ

The nation's third-largest, non-profit, secular healthcare system, North Shore-LIJ delivers world-class clinical care throughout the New York metropolitan area, pioneering research at The Feinstein Institute for Medical Research and a visionary approach to medical education, highlighted by the Hofstra North Shore-LIJ School of Medicine. North Shore-LIJ cares for people at every stage of life at 16 hospitals, long-term care facilities and nearly 400 ambulatory care practices throughout the region. North Shore-LIJ’s owned hospitals and long-term care facilities house more than 6,000 beds, employ more than 10,000 nurses and have affiliations with more than 9,400 physicians. With a workforce of more than 44,000, North Shore-LIJ is the largest employer on Long Island and the third-largest private employer in New York City. For more information, go to www.northshorelij.com.

About UnitedHealthcare

UnitedHealthcare is dedicated to helping people nationwide live healthier lives by simplifying the health care experience, meeting consumer health and wellness needs, and sustaining trusted relationships with care providers. The company offers the full spectrum of health benefit programs for individuals, employers and Medicare and Medicaid beneficiaries, and contracts directly with more than 650,000 physicians and care professionals and 5,000 hospitals nationwide. UnitedHealthcare serves more than 38 million people and is one of the businesses of UnitedHealth Group (NYSE: UNH), a diversified Fortune 50 health and well-being company.  

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