PATH Program. Getting Started Guide

Transcription

1 PATH Program Getting Started Guide

2 We have a BIG opportunity. Together, we can empower and encourage people to take an active role in their health. Preventive health care services help people find and treat diseases early or may prevent them from happening in the first place. But preventive health care takes motivation and planning. At UnitedHealthcare, we re on a mission to motivate and support our Medicare Advantage plan members in accessing the preventive care they need to lead longer and healthier lives. To be successful, we need YOUR help.

3 Introducing... PATH An innovative program from UnitedHealthcare that follows our model for patient, payer and care provider collaboration. PATH offers support to care providers who encourage their UnitedHealthcare Medicare Advantage patients to become more engaged with their preventive health care. The program focuses on specific quality of care measures for common and sometimes preventable or manageable health issues.

4 It s about patients. Not paperwork. How does the PATH program work? You will receive regular reporting, data and even administrative support from UnitedHealthcare to help you identify and address open patient care opportunities. You may earn financial incentives for meeting certain quality care goals, too. Your patients, who are UnitedHealthcare Medicare Advantage plan members, will receive the preventive care they need, which may help improve their overall health and wellness. We will work with you to help members be engaged with their health and your plan of care for them. The goal is to improve quality care measures for patients as a team.

5 What s in it for you? Tools and Support To help you identify patients who may have open care opportunities, you ll receive access to a personalized Patient Care Opportunity Report (PCOR) that details patient- and practice-level data about care visits, tests and screenings. In some cases, we may also provide administrative support to you and your practice to do things like review charts, schedule exams, collaborate with nurses, social workers and practice staff, or make follow-up calls to our members. Member Communications We communicate year-round with our Medicare Advantage plan members about the importance of taking proactive steps to keep their health on track. We ll also share information with you about our member programs throughout the year. Quality Measure Reference Center In today s market, care provider and payer performance is measured against several different quality measures. UnitedHealthcare is here to help you understand each of these measures so you can meet performance criteria along with the needs of your patients. Financial Incentives and Recognition We appreciate the extra time it takes you to participate in PATH. That s why we ve created incentives and rewards to compensate you for your efforts on behalf of our members.

6 Getting started with PATH.

7 You ll get tools and support to help your practice and your patients. Our tools and information resources can help make it faster and easier for you to complete the administrative work associated with PATH.

8 It all starts with your PCOR. The Patient Care Opportunity Report (PCOR) helps you identify where to focus so you can have the greatest influence. Transparent access to the bigger patient story allows you to see a patient s health history and experiences with other care providers. Patient pharmacy monitoring provides you with information on your patient s medication adherence through real-time behavior tracking. Practice-level data management and performance tracking shows your progress related to care opportunities. PATH reports are updated each month and available online so you can quickly access the information you need, when you need it.

9 We want to do our part to engage members with their health care. We encourage members to work with you to create a personalized preventive care plan. We remind members of annual visits, tests and screenings. We follow up with members to make sure they're following your recommendations. We support eligible members who have chronic conditions with disease management programs. We reward members who complete their annual care visit.

10 You ll have access to the Quality Measure Reference Center. It's your source for up-to-date information about quality care measures and the best ways to report patient data. And you can learn how quality measures may affect your practice, including: Centers for Medicare & Medicaid Services (CMS) Updates CMS Star Ratings Healthcare Effectiveness Data and Information Set (HEDIS ) Consumer Assessment of Healthcare Providers and Systems (CAHPS) Survey Health Outcomes Survey (HOS) And More

11 Finally, you can earn financial incentives. PATH financial incentives are made up of two components: PATH Bonus Your practice may earn a PATH bonus by achieving an average CMS Star Rating of 3.76 or higher. The higher your average Star Rating, the higher your bonus. Meaningful Use Data Exchange Bonus Your practice may earn an additional bonus for participating in meaningful use data exchange (MUDE) with UnitedHealthcare.

12 We re in this together. Let s get started. Through PATH, we re committed to working with you and providing support along the way so you can focus on what really matters your patients health. To get started, please contact your local UnitedHealthcare team.