UCARE MINNESOTA

UCARE ORGANIZED AND OPERATED A HEALTH MAINTENANCE ORGANIZATION (HMO) PROVIDING COORDINATED HEALTH CARE AND COVERAGE FOR APPROXIMATELY 500,000 INDIVIDUALS FROM THE COMMUNITY ENROLLED IN STATE GOVERNMENT PROGRAMS, FEDERAL MEDICARE ADVANTAGE PROGRAMS, DUALLY ELIGIBLE MEDICARE, AND MEDICAID PROGRAMS, AND MNSURE MARKETPLACE PLANS. UCARE'S PROGRAMS PROVIDE SERVICES TO SENIORS, LOW-INCOME FAMILIES, THOSE WITH PHYSICAL DISABILITIES, AND OTHER INDIVIDUALS WHO MAY HAVE CHALLENGES ACCESSING HEALTH CARE. UCARE IS DEDICATED TO PROMOTING THE HEALTH OF THE COMMUNITY IT SERVES AND MAKES QUALITY HEALTH CARE AVAILABLE ON AN ECONOMICALLY ADVANTAGEOUS, PREPAID BASIS TO THAT COMMUNITY. OUR SERVICES ARE GUIDED BY UCARE'S MISSION WHICH IS TO IMPROVE THE HEALTH OF OUR MEMBERS THROUGH INNOVATIVE SERVICES AND PARTNERSHIPS ACROSS COMMUNITIES. THROUGHOUT EACH AREA, UCARE IMPLEMENTED INTERVENTIONS THAT MET THE NEEDS OF OUR CULTURALLY AND ETHNICALLY DIVERSE MEMBERSHIP THAT INCLUDED: - STRUCTURAL INTERVENTIONS INCLUDING ACCESSIBILITY AND AVAILABILITY OF PRIMARY CARE, MENTAL HEALTH AND SUBSTANCE USE DISORDER, AND SPECIALTY CARE PROVIDERS; VALUE-BASED CONTRACTING; AND MEDICAL RECORD STANDARDS AND ADVANCE DIRECTIVE AUDITS. - COMMUNITY RESOURCES INCLUDING MEMBER WELLNESS AND SAFETY INITIATIVES; COMMUNITY PARTNERSHIPS, SOCIAL SERVICES REFERRALS. - TAILORED INTERVENTIONS TO SUPPORT NCQA, HEDIS, STAR RATINGS, QUALITY RATING SYSTEM, CAHPS, HOS, MEMBER EXPERIENCE, MEMBER SAFETY, FOCUSED STUDIES, DISEASE MANAGEMENT AND CARE MANAGEMENT PROGRAMS. THE QUALITY MONITORING, PROGRAM INITIATIVES AND SERVICES DEMONSTRATED MANY SIGNIFICANT ACTIVITIES AND OUTCOMES. MANY PERCENTAGES OF MEASURE ELEMENTS MET OR EXCEEDED THE NATIONAL NCQA 75TH PERCENTILE FOR UCARE'S PRODUCTS MEDICARE STAR RATINGS PROGRAM: CMS CONTINUES TO MAKE SIGNIFICANT MEASUREMENT CHANGES THAT MAKE IT HARDER FOR PLANS TO MAINTAIN AND ACHIEVE HIGH RATINGS. THE NATIONAL AVERAGE STAR PERFORMANCE DECLINED FOR THE THIRD YEAR IN A ROW, WITH ONLY SEVEN 5-STAR PLANS REMAINING FOR THE 2025 PLAN YEAR - NONE IN MINNESOTA. UCARE PLANS EXPERIENCED STAR LOSSES BUT RETAINED HIGH RATINGS FOR OUR UCARE MEDICARE AND ESSENTIACARE PLANS. UCARE MEDICARE RECEIVED A 4 STAR AND ESSENTIACARE RECEIVED A 4.5 STAR. MSHO AND CONNECT + MEDICARE DECREASED BY A HALF STAR FOR THE 2025 PLAN YEAR, DROPPING TO A 3.5 STAR AND 3 STAR RESPECTIVELY. OVERALL, SPECIAL NEEDS PLANS (SNP) OFFERED IN MINNESOTA DROPPED IN STAR RATINGS FOR THE 2025 PLAN YEAR. THIS WAS THE FIRST YEAR THAT UCARE YOUR CHOICE QUALIFIED FOR AN INDIVIDUAL STAR RATING AND EARNED 3.5 OUT OF 5 STARS. UCARE CONTINUOUSLY STRIVES TO IMPROVE THE HEALTH OF MEMBERS. UCARE IDENTIFIED KEY FOCUS AREAS THAT SUPPORT QUALITY MEASURE PERFORMANCE ACROSS ALL PRODUCTS WITH A CONTINUED FOCUS ON IMPROVING AT OR ABOVE THE NATIONAL 75TH PERCENTILE AND MAINTAINING OR ACHIEVING HIGH PERFORMANCE IN OUR STAR RATINGS PROGRAM FOR MEDICARE AND INDIVIDUAL AND FAMILY PLANS. UCARE PROVIDED MANY HEALTH PROMOTION, DISEASE MANAGEMENT, CARE MANAGEMENT AND WELLNESS PROGRAMS. THESE EFFORTS NOT ONLY BENEFIT THE HEALTH OF ENROLLEES, BUT POSITIVELY AFFECT THEIR FAMILIES AND LARGER COMMUNITIES. EXAMPLES INCLUDE: DISEASE MANAGEMENT PROGRAMS FOR ASTHMA, DIABETES, CHRONIC KIDNEY DISEASE, AND CONGESTIVE HEART FAILURE; FALLS PREVENTION PROGRAMS TO IMPROVE SAFETY OF SENIORS; MANAGEMENT OF MATERNITY SERVICES (MOMS) PROGRAMS THAT PROVIDE RESOURCES TO ENROLLEES AND PROVIDERS TO IMPROVE PREGNANCY AND POST-PARTUM HEALTH, CAR SEAT DISTRIBUTION, EDUCATION TO PREGNANT WOMEN AND CHILDREN; TOBACCO CESSATION PROGRAMS AND SERVICES TO HELP MEMBERS LIVE NICOTINE FREE, AND DISTRIBUTION OF FREE MATERIALS ON HEALTH EDUCATION AND PROPER USE OF URGENT AND EMERGENCY FACILITIES AT COMMUNITY FORUMS. IN ADDITION, UCARE SUPPORTS MEMBER HEALTH WITH ACCESS TO MANY DIFFERENT FITNESS OPTIONS AS WELL AS DISCOUNTS ON SERVICES THAT ARE HEALTH AND WELLNESS RELATED BUT MAY NOT BE COVERED BY THE MEMBER'S BASIC BENEFIT PLAN, INCLUDING HEALTHY FOOD DISCOUNTS, ALTERNATIVE MEDICINE AND COMMUNITY EDUCATION CLASSES AND OVER-THE-COUNTER MEDICATION ALLOWANCE. UCARE CONDUCTED A VARIETY OF HEALTH-RELATED EDUCATIONAL SESSIONS, TOOLS AND MATERIALS FOR MEMBERS, PROVIDERS, AND THE PUBLIC. IN 2024, UCARE CONDUCTED 244 MEDICARE EDUCATION CLASSES WHICH WERE ATTENDED BY 750 INDIVIDUALS. UCARE PARTNERED WITH WELLSHARE INTERNATIONAL TO PROVIDE EDUCATIONAL OPPORTUNITIES FOR DIVERSE POPULATIONS AND WITH THE SOMALI COMMUNITY TO CONDUCT CULTURALLY APPROPRIATE HEALTH EDUCATION CLASSES FOR COMMUNITY FAMILIES, ELDERS AND IMAMS REGARDING PREVENTATIVE CARE AND CHRONIC CONDITION MANAGEMENT. UCARE ALSO PRODUCED NUMEROUS NEWSLETTER ARTICLES EDUCATING BOTH MEMBERS AND PROVIDERS ABOUT VARIOUS TOPICS, INCLUDING DENTAL BENEFITS, CHRONIC CONDITION MANAGEMENT, NEW PROVIDER SEARCH TOOL, MEDICARE COVERAGE UPDATES AND CAREGIVING SUPPORT FOR FAMILIES. IN A TYPICAL YEAR, UCARE PROVIDES HEALTH RELATED SCREENINGS AND SERVICES THAT ARE AVAILABLE AT NO OR LOW COST TO MEMBERS AND THE PUBLIC. UCARE SUPPORTS PROVIDING FREE HEALTH RELATED SCREENINGS, FLU AND COVID SHOTS, AND HEALTH EDUCATIONAL INFORMATION TO THE GENERAL PUBLIC VIA THE UCARE HEALTHMOBILE (A 37-FOOT RV THAT PROVIDES FREE BASIC HEALTH SCREENINGS INCLUDING BLOOD PRESSURE CHECKS, GLUCOSE AND CHOLESTEROL READINGS AND BODY MASS INDEX (BMI) ASSESSMENTS) AT VARIOUS COMMUNITY EVENTS. UCARE'S MOBILE DENTAL CLINIC (MDC), OPERATED WITH THE UNIVERSITY OF MINNESOTA'S SCHOOL OF DENTISTRY, OFFERS QUALITY ORAL HEALTH CARE TO UCARE MEMBERS WITH DENTAL ACCESS ISSUES. IN 2024, THE MDC STAFF PERFORMED MORE THAN 3,654 PREVENTIVE AND RESTORATIVE PROCEDURES AT SITES ACROSS MINNESOTA. UCARE TARGETED AREAS OF THE STATE WITH LIMITED DENTAL ACCESS FOR INDIVIDUALS ON STATE PUBLIC PROGRAMS. UCARE HEALTH PLAN EMPLOYEES ALSO DEVOTED TIME TO PARTICIPATE IN COMMUNITY RELATED COLLABORATIONS AND PARTNERSHIPS THAT SUPPORT EFFORTS TO IMPROVE HEALTH CARE QUALITY AND RESEARCH INITIATIVES, ADVANCE PUBLIC HEALTH AND HEALTH CARE ACCESS, AND REDUCE HEALTH CARE DISPARITIES OR SOCIAL DETERMINANTS OF HEALTH, INCLUDING PROJECTS AIMED AT IMPROVING THE CULTURAL COMPETENCE OF HEALTH CARE DELIVERY. EXAMPLES OF ORGANIZATIONS AND COLLABORATIONS WITH WHICH UCARE EMPLOYEES WORKED INCLUDE: MINNESOTA COMMUNITY MEASUREMENT, MN HOMELESS, AND PARENTS IN COMMUNITY ACTION HEAD START, HMONG AMERICAN PARTNERSHIP, MINNESOTA HEALTH LITERACY PARTNERSHIP, LOCAL PUBLIC HEALTH ASSOCIATION OF MINNESOTA, AND THE MULTILINGUAL HEALTH RESOURCE EXCHANGE.