Standard Care Coordination Expansion Pilot

Launched by UNITEDHEALTHCARE · Jun 1, 2020

Keywords

ClinConnect Summary

The Standard Care Coordination Expansion Pilot is a clinical trial aimed at helping individuals who frequently use healthcare services, known as "superutilizers." This program, designed by UnitedHealth Group, seeks to improve access to care and make healthcare decisions easier for those at high risk of needing hospital care again. Currently, only certain individuals can participate, but this trial will look at whether expanding the program to more members who are identified as high risk can reduce the need for hospital admissions.

To be eligible for this trial, participants must be at least 18 years old, enrolled in UnitedHealthcare's commercial insurance plans, and identified as high risk due to their healthcare needs. However, pregnant women and those with certain health conditions, like dementia, cannot participate. If you join the trial, you can expect support from care coordinators who will help you navigate your healthcare options. The goal is to see if this expanded support can lead to better health outcomes and fewer hospital visits.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • UnitedHealthcare commercial Fully Insured members; all states; 18+ years old; actively enrolled in the health plan as of randomization identified via proprietary administrative algorithm as being at high risk for persistent super utilizer status.
• Exclusion Criteria:
• * : pregnant women, individuals prescribed medications for infertility, members with evidence of dementing disorders, members indicated as "do not contact " for program outreach, and Members in the following products and plans:
• • legacy UHC ASO groups (populations for which UHC provides administrative services only),
• • legacy Oxford health plan members (all members receive the SCC program),
• • legacy PacifiCare members,
• • legacy River Valley/NHP members, and
• • Public Sector clients
• • the PHS 2.0 intervention (a small population within Fully Insured)
• • assignment to a clinically activated Accountable Care Organization (ACO)