Facing a total knee replacement, UnitedHealthcare Medicare Advantage member Melinda Lacy found guidance, support and a "best friend" through the Navigate4Me program. (Source: UnitedHealthcare)
UnitedHealthcare announced that it will increasingly leverage data from digital devices flowing into the UnitedHealthcare Nerve Center to help people enrolled in its Medicare Advantage plans more effectively manage chronic conditions.
The data is being used to enhance secure, comprehensive health profiles for UnitedHealthcare Medicare Advantage plan participants that are generated through the UnitedHealthcare Nerve Center. UnitedHealthcare navigators use those profiles to provide personalized, holistic support for people through the Navigate4Me program, which the company is expanding in 2019.
UnitedHealthcare launched Navigate4Me in fall 2017 to better serve people enrolled in its Medicare Advantage plans who are facing complex health issues such as diabetes, congestive heart failure, multiple chronic conditions, or sudden health events such as joint replacement surgery or a new cancer diagnosis.
Navigate4Me enables holistic, whole-person care. Nurses and highly trained customer service advocates serve as health navigators who help people alleviate the burden of managing a serious health issue. Navigators provide support with both clinical and administrative needs, ranging from answering health questions and resolving claims or billing issues to helping people follow a personalized care plan, coordinating care and helping to address social determinants of health, such as connecting people with reliable transportation or housing assistance.
The Nerve Center is a digital platform and data hub that operates like a command center for UnitedHealthcare navigators, pulling data from a variety of sources, including claims, clinical and demographic information, and digital devices such as wearables and sensors, to build comprehensive health profiles for plan participants. These secure profiles give health navigators the full picture of a person's health, including everything from routine checkups and recent emergency room visits to information transmitted via wearables and sensors showing how well they are managing their conditions or adhering to their doctor's treatment recommendations.
Based on analysis of the health profiles, the Nerve Center helps navigators identify future health actions that could be appropriate for each person, anticipate upcoming care needs, and continuously screen for risk factors. This actionable information enables health navigators and other members of the care team to focus their engagement efforts on the people in most need of support, based on their likelihood of experiencing a negative health event such as a hospitalization or a worsening of their symptoms.
It also arms the navigators with personalized information that can help patients and care providers choose the best clinical approach and close gaps in care. When appropriate, the Nerve Center will also integrate data directly into doctors' electronic medical records, helping them deliver more evidence-based care to their patients enrolled in UnitedHealthcare Medicare Advantage plans.
The digital infrastructure feeding the Nerve Center includes devices used in the management of some of the most common and costly conditions in older adults as well as the care of people recovering from a hospitalization. Some examples:
- Congestive Heart Failure: Patients use a Bluetooth-enabled tablet, scale and blood pressure monitor to manage and monitor their condition in partnership with their doctor and with support from the UnitedHealthcare care team. Daily prompts to record their weight and answer questions via the tablet can identify sudden spikes in weight that could signal that the heart isn't pumping properly, putting the patient at risk of hospitalization.
- Diabetes: UnitedHealthcare health coaches access data from connected glucose monitors, smartphones and fitness trackers. Because the data is more thorough as compared to readings from manual, intermittent finger sticks, the coaches are able to deliver more effective and personalized coaching based on lifestyle factors. For example, if the data shows that exercise following a meal helps lower glucose levels to the ideal range, the coaches can guide people to more effectively manage their symptoms through the timing of their workouts.
- Post-Acute Care: People who have been discharged from the hospital to a skilled nursing facility wear a small adhesive patch that sends vital-sign data continuously through a Bluetooth sensor. The data is gathered and analyzed to help detect issues that could lead to an emergency room visit or a readmission.
The more timely engagement opportunities and proactive interventions made possible by these advances in care management are designed to improve people's well-being while avoiding preventable hospitalizations.
"We're building the next generation of care management by moving away from traditional models to a holistic approach that harnesses the power of real-time data and technology to deliver the right kind of individual support that can help people get well and stay well," said Brian Thompson, CEO of UnitedHealthcare Medicare & Retirement. "Combining new data-driven insights with the human touch of our care teams will deliver a more personalized health experience."
Modernizing Care for Today's Seniors and Other Beneficiaries
Navigate4Me and the Nerve Center are part of UnitedHealthcare's efforts to modernize the way it cares for the people enrolled in its Medicare Advantage plans as the baby boomer generation continues aging into Medicare.
Nearly 40 percent of the people enrolled in UnitedHealthcare's Medicare Advantage plans have four or more chronic conditions, and nearly the same percentage live alone. These individuals are especially vulnerable when dealing with serious health issues and trying to navigate a complicated health care system, yet many are digitally savvy and accustomed to leveraging technology and mobile tools to manage other areas of their lives.
With the support of dedicated health navigators and enhanced insight into people's health through digital devices, UnitedHealthcare aims to personalize the health experience for Medicare beneficiaries and improve their health and quality of life.
More people have chosen UnitedHealthcare to provide their Medicare coverage than any other company.i UnitedHealthcare serves more than 12.5 million people enrolled in Medicare, including more than 4.9 million people in Medicare Advantage plans, more than 4.7 million people in stand-alone Part D prescription drug plans, and more than 4.5 million people in Medicare supplement plans.
About UnitedHealthcare
UnitedHealthcare is dedicated to helping people live healthier lives and making the health system work better for everyone by simplifying the health care experience, meeting consumer health and wellness needs, and sustaining trusted relationships with care providers. In the United States, UnitedHealthcare offers the full spectrum of health benefit programs for individuals, employers, and Medicare and Medicaid beneficiaries, and contracts directly with more than 1.2 million physicians and care professionals, and 6,500 hospitals and other care facilities nationwide. The company also provides health benefits and delivers care to people through owned and operated health care facilities in South America. UnitedHealthcare is one of the businesses of UnitedHealth Group (NYSE: UNH), a diversified health care company. For more information, visit UnitedHealthcare at www.uhc.com or follow @UHC on Twitter.
Plans are insured through UnitedHealthcare Insurance Company or one of its affiliated companies, a Medicare Advantage organization with a Medicare contract. Enrollment in the plan depends on the plan’s contract renewal with Medicare.
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i CMS enrollment data and UnitedHealthcare internal data, 2019
Statistics in this release can be attributed to 2019 UnitedHealthcare internal data.
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