UnitedHealth Group - Assignment Example

United Healthcare case study United Healthcare is a diversified health care company operating in the United States. The headquarters of the firm are in Minnetonka, Minnesota. The firm offers a spectrum of services and products through two businesses; Optum and UnitedHealth. Through its sub-branches, the UnitedHealth group serves about 70 million individuals across the United States. In 2011, the company had net earnings of $5.142billion. UnitedHealth group is the mother of United Healthcare founded in 1977 as unites healthcare cooperation. The firm has two foundations, namely, the United Healthcare Children Foundation and the United Healthcare Foundation that were announced in 1999. The foundations are heavily involved in providing information that helps in decision-making within the US that promote better health outcomes and healthy populations, like in their partnership with the America’s Health Rankings. In addition, the foundations are involved in supporting activities that sponsor quality health care for the less fortunate through collaborations with other counterpart organizations (Duderstadt, 2013). Internal assessment United Healthcare, through its human resource department, maintains a sustainable working environment. The department, through collaborations with outside occupational health service providers, conducts an annual assessment on the workforce management activities. The United Healthcare foundations, through their human resource department conduct research on workers’ welfare, patient facilities, and conducts work force analyses. The firm analyzes its databases, and the physician supply and demand models to understand current issues and forecast future possible outcomes ascribed to the delivery of healthcare. In understanding the integrated nature and the complexity of the subject matters at hand, the firm constantly researches on modus operandi adopted by pharmacists, individual physician specialist and nurses among others (Duderstadt, 2013).. Employing laborious, data-driven researches, the firm is actively involved in gathering, analyzing and synthesizing her research findings in highly accessible action formats and policies. United Health foundation helps its clients to disseminate research results through publications and peer-reviewed journals. Innovations United Healthcare is dedicated to changing health care through testing and exploration, and by developing new ideas, and cooperating with different partners to advance simpler, cost-effective and more intelligent health care schemes for everybody. The firm’s efforts focus on leveraging information and technology to connect clinicians and patients in a way that breaks down outdated barriers of care. For instance, the firm has managed to come up with groundbreaking innovations like baby blocks, which is a free online interactive motivational program designed to help new mothers and pregnant women with parental and good baby care. It also employs the use of telemedicine- this is a program put in place to serve approximately 300 and more Navajo children with complex medical issues based in Utah, Arizona, and New Mexico. Thirdly, the organization combines the human touch of home medicinal checkups with advanced technology and directed medical health tutoring to advance the quality of health of senior citizens (Duderstadt, 2013). Patient satisfaction United Healthcare is assessing various value-based contraction strategies. This is assessment is meant to improve patient outcomes, reduce medical costs and share responsibility as well as the risk of controlling medical costs. The firm considers the Accountable Care Organizations (ACOs) as an important asset of its value-based contracting plans. Through the program, the firm aims to move the delivery system towards increased partnerships between the heath care communities. In addition, the firm seeks to increase emphasis on share responsibility and risk accountability and improved patient outcomes (Figueroa, 2012). The patient protection and affordable care act enacted in 2010 has provisions surrounding the establishment of Accountable Care Organizations under the Medicare shared savings plan. Under the final rule issued by the Medicaid and Medicare services, ACO is described as a group of hospitals, physicians, and other medical service-providing organizations in collaboration. These entities cooperate and share loses or profits for Medicare individuals ascribed to their group. United Healthcare is planning to capitalize on this program to offer her clients affordable services. There is increased transformation in the industry-payment model. Because of the transformation, there is need for various strategies to fit the requirements and diversity of consumers and health care physicians in given communities. United Healthcare is presently chasing a range of value-based contracting schemes from performance-based contracting motivations. In addition to these important models, United Healthcare is presently active with one ACO pilot in Tucson, Arizona, and is planning on adding 8-12 more pilot projects across the United States (Figueroa, 2012). Network expansion. Through established Medicaid programs growing through ACA expansions, increased establishments of eligible Medicaid, prospected identification through state and federal exchange markets, and as the dual eligible MME initiative begin to form, the firm hopes to realize growth through collaborations. Currently, the insurer is in collaboration with more than 57 hospitals, 1,100 medical groups, and more than 76,0000medcal specialists. Depending on the ability of a given firm to assume financial risks and affect health outcomes, the insurer is planning to offer varying levels of collaborations. This strategy is aimed at ensuring maximum collaboration with other insurance firms. The firm adopts the strategy to offer ACO plans based on employer-sponsored, Medicaid and Medicare plans (Figueroa, 2012). Nurse staffing United Healthcare plans to hire approximately 125 medical personnel, predominantly registered nurses and nurse experts with good paying positions and salaries of up to $92,000. The staff will be heavily involved in making house calls for clients covered by medical Medicare who face potentially expensive conditions or who suffer chronic conditions such as congestive heart failure and cancer. It is an investment that United Healthcare hopes will improve patients’ health through higher quality care, which is more cost-effective, and in turn, boosts the firm’s bottom line (Guo, 2008). The move is part of a wider insurance business thrust towards providing direct clinical care to those covered by their products. The firm is increasingly collaborating with medical providers in sharing claims and investing in medical personnel and staff to provide quality services to their clients. The increased numbers of retirees in the firm accelerates the need to hire more personnel. The clinical employments for the firm are part of its new House-Calls plan that is already operating in Florida, Maryland and lately in North Carolina. The program aims at helping to identify gaps within the firm’s services and giving personalized visits by nurses and practicing nurses or home-calls to UnitedHealth clients. The House-Calls team will make approximately ten calls a day. Like Other moves that seek to espouse the delivery of quality over quantity in medical health care, the increased nurse hiring is aimed at increasing coordinated care and collaboration efficiency (Guo, 2008). Resource management plan United Healthcare’s management has various departments that are involved in resource management. The HR department is mandated with the recruitment of new employees. The department has an extensive program dedicated to training younger employees to ensure sufficient availability of trained personnel. The department also ensures that the retirees receive their pensions in time and in line with the United States’ laws. The department provides analytical service assessments that covers the whole workforce management from predicting supply and demand, to developing actions and implications, and finally explaining and disseminating results (Duderstadt, 2013). In terms of delivering high-quality service, the farm ought to get involved in: Modeling Future Supply and Demand Develop models that are used in projecting future supplies and demand for their clients and patient care clinicians (Duderstadt, 2013). Continuously conduct an examination of the programs and policies that affect workforce retention and recruiting. Program Evaluation Conduct a critical analysis of programs affecting patients and staff Study and document any implications ascribed to workforce policies. Design and perform a rigorous evaluation of all the programs affecting the workforce Collect sufficient data and provide technical assistance Research and document any consequences tied to workforce policies (Duderstadt, 2013). References Duderstadt, K. G. (2013). Affordable Care Act: States Move Forward With Health Reform. Journal of Pediatric Health Care, 27(2), 158-160. Figueroa, J. A. (2012). Fighting for Our Health: The Epic Battle to Make Health Care a Right in the United States Fighting for Our Health: The Epic Battle to Make Health Care a Right in the United States Richard Kirsch , Albany, N.Y.: The Rockefeller Institute Press. 2012. 416 p. Inquiry, 49(4), 362-363. Guo, K. L. (2008). Quality of health care in the US managed care system: Comparing and highlighting successful states. International Journal of Health Care Quality Assurance, 21(3), 236-248. Read More