A simplified approach to helping members find quality, cost-efficient care

A simplified approach to helping members find quality, cost-efficient care

When it comes to selecting a safe vehicle, a new phone or a meal at a restaurant, a good rating may make all the difference. But when it comes to choosing a health care provider, it may be more difficult to decide how to make an informed choice.

To help members make guided decisions about their health care, the UnitedHealth Premium® program recognizes doctors who meet quality and cost-efficiency criteria and notes the designation with a simple graphic near the physician’s name on the member portal.

The ranking designations appear as a series of colored hearts:

If a physician does not have a Premium Care Physician or Quality Care Physician designation, it does not mean the physician does not provide quality health care services. All physicians in the UnitedHealthcare Network have met certain minimum credentialing requirements, which is separate from the Premium program.

UnitedHealth Premium Care Physicians:

  • Follow evidence-based guidelines for care
  • May be more likely to be aware of the latest research and clinical trials
  • May have lower surgery repeat rates

Poor quality care may lead to higher complication and surgical-repeat rates, unnecessary hospitalizations and a higher chance of a wrong diagnosis. By supporting and promoting doctors who meet the Premium program’s quality benchmarks using national standardized measures and local benchmarks for cost efficiency, the member’s decision-making process may become easier.

Additionally, the program may help achieve:

  • Better long-term health outcomes
  • Improved overall experiences
  • Reduced health care costs

To make the designations, the Premium program uses clinical quality measures from the National Quality Forum, American Medical Association Physician Consortium for Performance Improvement, National Committees for Quality Assurance, government agencies and other national experts.

Relevant measures from health plan claims data are then evaluated to help determine physician performance. The Premium program evaluates more than 390,000 doctors across most states.

Physicians are evaluated on cost efficiency based on factors such as the use and price of diagnostic testing, prescribed medications, procedures and follow-up care, in comparison to other doctors in the same Premium specialty geographic area.

For more information about the UnitedHealth Premium program, visit uhc.com.

The UnitedHealth Premium® designation program is a resource for informational purposes only. Designations are displayed in UnitedHealthcare online physician directories at myuhc.com®. You should always visit myuhc.com for the most current information. Premium designations are a guide to choosing a physician and may be used as one of many factors you consider when choosing a physician. If you already have a physician, you may also wish to confer with him or her for advice on selecting other physicians. You should also discuss designations with a physician before choosing him or her. Physician evaluations have a risk of error and should not be the sole basis for selecting a physician. Visit myuhc.com for detailed program information and methodologies.