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Care Coordination

Care Coordination- An Essential Component of Quality Health Care

Traditional Medicare, with its fee for service payment system, can sometimes shortchange seniors and other people with Medicare who depend on it for high-quality care. It also can shortchange the American taxpayer who too often pays for unnecessary and sometimes harmful care simply because there is no single medical professional coordinating patient care. The fragmentation of U.S. health care delivery leaves too many older Americans without the single primary care physician who can monitor and coordinate safe care.

Patients receive the best care when their doctors have the authority, tools and the incentives to serve their patients. For instance, Universal American works with primary care doctors to select specialty networks that are coordinated by the primary care doctor. Universal American then supports its physicians with well executed medical management services, providing financial, utilization, patient satisfaction and clinical data to the doctors for the benefit of their patients. Universal American also provides the systems support to integrate patient care across all settings – primary care, specialists and hospital care.

Primary care doctors who care for Universal American members in our network plans are paid not just for what they do in the exam room; they are paid to coordinate care so their patients can achieve the best possible health outcomes. Our TexanPlus® Medicare Advantage HMO Plans have successfully improved patient health outcomes under our collaborative model.

Our position

  • The United States’ healthcare system must adopt a model of coordinated care that changes the role of a primary care doctor from “exam room” quality to “total patient outcome” quality. This is the direction the United States health care system must take. Universal American creates local physician led organizations to manage and drive the best health outcomes for its members.

View the pending healthcare reform legislation.