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Quality Highlights

Quality Matters at UCare

Our Quality and Population Health Program supports our mission to improve our members' health by addressing health equity and health care disparities through innovative services and community partnerships. Every year, our Quality Program is evaluated to make sure it is effective and meaningful, and that it meets regulatory standards and guidelines. Results from our annual evaluation help us develop, prioritize and track our progress toward our quality plan goals.

Thanks to strong collaboration with our providers and community partners, UCare delivers measurably high-quality care to every one of our members. Quality monitoring and program initiatives continue to demonstrate positive outcomes.

Our programs



 

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2022 Medicare Star Ratings*

The Medicare Program rates all health and prescription drug plans each year, based on member experience surveys, health outcomes and quality of the healthcare provided to members. Medicare Star Ratings help you know how well our plan is doing. The scale ranges from one to five stars, with five being considered excellent. Star Ratings are based on five health service categories:

  1. Keeping members healthy through preventive screenings, vaccines and other check-ups
  2. Managing chronic (long-term) conditions
  3. Member satisfaction with their health plan, drug plan and provider
  4. Operational performance
  5. How well plans handle customer requests
The 2022 Star Ratings were released in October 2021 and apply to the 2022 Medicare Advantage plan year. UCare received the following Overall Star Ratings for our Medicare programs:

UCare Medicare – 5 Stars out of 5 Stars
Minnesota Senior Health Options – 4.5 Stars out of 5 Stars
UCare Connect + Medicare – 4 Stars out of 5 Stars
EssentiaCare – 4 Stars out of 5 Stars

* Star Ratings are assessed each year and may change from one year to the next.
 

Why do Star Ratings Matter?

You can use these Star Ratings to compare our plan’s performance to other plans to find the one that best meets your needs.

Medicare rewards plans that achieve four and five Star Ratings with a bonus payment that can only be used to reinvest back into plan benefits and programs. This means, the better UCare does to support you and your health care needs, the better our benefits for you can be in the future.

How can you help?

  • Schedule an Annual Wellness visit every year.
  • Receive your screenings and preventive care, including your flu shot and vaccines.
  • Complete and return all member surveys.
  • Discuss and monitor your physical and mental health with your doctor.
  • Work with your doctor or pharmacy to stay up-to-date on your medications.

How can I enroll in a 5-Star plan like UCare Medicare?

You can switch to a Medicare plan that has a 5-Star overall rating at any time once during the 5-Star Special Election period that is available from December 8, 2021 through November 30, 2022. People enrolled in a plan with a 5-Star overall rating may also switch to a different plan with a 5-star overall rating. 

To learn more, schedule a call with a licensed Medicare Sales Specialist by calling 612-676-3500, available 8am-8pm seven days a week (612-676-6810 & 1-800-688-2534 TTY).

 

NCQA Accredited

NCQA Health Plan Accreditation

In 2020, UCare’s full line of Medicare, Medicaid and Individual & Family health plans earned Health Plan Accreditation from the National Committee for Quality Assurance (NCQA). UCare has maintained a highly rated accreditation status since 2014 for UCare Medicare and Individual & Family Plans, and the expansion of accreditation of all UCare products attests to UCare’s commitment to the highest standards of quality.


 

Learn More About Our Quality Programs

The Quality Management Department annually reviews the quality work from the previous year, analyzes the progress toward our goals, and identifies new focus areas and goals for the upcoming year.

Quality Management Program Description 2022

Quality Management Program Evaluation Executive Summary 2021

Quality Management Program Work Plan 2022




 

2022 Health Insurance Exchange Quality Ratings System

The Centers for Medicare and Medicaid Services (CMS) administers the Quality Ratings System (QRS) to measure the overall quality of care and services provided by Quality Health Plans (QHPs) to its members. The scale ranges from one to five stars, with five being a high performing health plan and one being a low performing health plan. You can use these Star Ratings to compare our plan’s performance to other plans.

A plan's overall rating is based on three categories, each with its own star rating:

  • Member experience: Based on surveys of member satisfaction with:
    • Their health care and doctors
    • Ease of getting appointments and services
  • Medical care: Based on how well the plan's network providers manage member health care, including:
    • Providing regular screenings, vaccines, and other basic health services
    • Monitoring some conditions
  • Plan administration: Based on how well the plan is run, including:
    • Customer service
    • Access to needed information
    • Network providers ordering appropriate tests and treatment

Due to coronavirus disease 2019 (COVID-19) emergency, ratings for 2021 plan year (2020 Star Ratings) are based on data provided in 2019.

UCare received the following Overall Star Rating for our programs: UCare Individual & Family Plans - 4 Stars




 

Member Satisfaction

The Centers for Medicare & Medicaid Services (CMS) and Department of Human Services (DHS) gauges member satisfaction of Medicare Advantage and Medicaid plans through an annual survey called the Consumer Assessment of Healthcare Providers and Systems Survey (CAHPS Survey). CMS also administers a member experience survey to marketplace health plans called the Qualified Health Plan Enrollee Survey (QHP Enrollee Survey). The CAHPS and QHP surveys helps health plans identify opportunities to improve quality and services, and helps CMS and DHS monitor the quality and performance of these plans.

UCare scored above the national average on several 2021 measures. UCare has identified the following focus areas and improvement opportunities for 2022 for all health plan members:

Focus area Improvement opportunities
Customer Service
  • Increase focus on communication and customer service delivery excellence to drive positive interactions with our members and drive member trust
  • Continue to train Customer Service representatives on motivational interviewing techniques to improve member interactions
Rating of Health Plan
  • Continue member outreach strategies including, but not limited to: IVR calls, telephonic outreach, member mailings (e.g., survey and formulary changes), etc
  • Continue to partner with culturally competent community service providers to improve member health outcomes and health equity 
Rating of Drug Plan
  • Continue analyzing the drug formularies and reviewing feedback from internal data sources to better understand the prescription drug needs of our member populations
  • Improve member communication of formulary changes

 


 

UCare's Quality Improvement Initiatives

UCare's Quality Improvement Initiatives

The Quality Management and Population Health Program is committed to innovation, affordability, professional competence and continuous learning, teamwork, and collaboration. The program places an emphasis on addressing health equity and health care disparities of our members. Further, quality of care and services are optimized and continuously improved while maintaining cost-effective utilization of health care resources. This is accomplished by systematic monitoring and evaluation of provided services and by actively pursuing opportunities for improvement. 

 

Improving dental utilization and access

UCare Products: UCare Connect (SNBC), UCare Connect + Medicare (HMO D-SNP), MinnesotaCare, Minnesota Senior Care Plus (MSC+), UCare’s Minnesota Senior Health Options (MSHO) (HMO D-SNP)

Measure: Annual dental visits

Goal: Increase dental utilization to improve dental rates for our members

Member resources UCare interventions Community collaboration
 
  • Training & education for UCare Care Coordinators
  • Telephonic outreach to members who are overdue for a dental visit
  • Education for members & providers on using UCare Dental Connection
  • Provider education on referring members for dental visits
  • Removing prior authorization requirements for additional cleanings
 

 

If you need assistance in finding or locating a dental provider, please call UCare Dental Connection at 651-768-1415 or 1-855-648-1415 (toll free), or TTY: 711, from 7 am – 7 pm, Monday – Friday. Additional Customer Service hours and days of operation, and phone numbers are here.





 

Current Performance Improvement Projects:

Commencing in 2021 and continuing through 2023, UCare is working together with a collaborative group of Minnesota Managed Care Organizations (MCO) and the Department of Human Services (DHS) to improve the quality of care for Minnesota enrollees. To learn more about the Collaborative Health Plan Performance Improvement Projects (PIPs), visit the Stratis Health Website.  

 

Healthy Start for Mothers and their Children

This Performance Improvement Project (PIP) is intended to promote a “Healthy Start” for Minnesota children in the PMAP and MnCare populations by focusing on and improving services provided to pregnant members, infants, and children particularly in areas exhibiting the most significant racial and ethnic disparities.

UCare Products: Prepaid Medical Assistance Program (PMAP), MinnesotaCare

Measures: Timeliness of Prenatal and Postpartum Care, Well Child Visits (Ages 0-30 months – 6 or more visits in first 15 months and 2 or more visits from 16-30 months), Childhood Immunization Status (Combo 10)

Goals: Improve timeliness of prenatal care & postpartum care, increase well child visit rates, decrease health disparities

 Member Resources UCare Interventions  Community Collaboration 
  • Provide Case Management for Prenatal and Postpartum care to members
  • Telephonic outreach to members identified as pregnant
  • Community-based engagement
  • Provide education and resources to members
  • Improving provider partnerships
  • Conducting a benefit assessment to ensure members have access to needed services during pregnancy
  • Create a tool to connect members to social services and community resources
 


Comprehensive Diabetes Care

This Performance Improvement Project (PIP) is aimed at improving Comprehensive Diabetes Care and services for Seniors and our Special Needs members with the focus on health care disparities. Race or ethnicity, sex, sexual identity, age, disability, socioeconomic status, and geographic location all contribute to an individual’s ability to achieve good health.

UCare Products: UCare’s MSHO, UCare Connect, UCare Connect + Medicare, MSC+

Measures: Comprehensive Diabetes Care (HbA1c testing, Nephropathy screening, Diabetic Eye Exam)

Goals: Improve Comprehensive Diabetes Care for members across all three measures with a focus on improving health care disparities

MEMBER RESOURCES UCARE INTERVENTIONS COMMUNITY COLLABORATION
  • Improve community outreach and partnerships
  • Create a tool to connect members to social services and community resources
  • Improve provider partnerships
  • Use analytics and predictive modeling to assess the impact of member preferences for communication and determine intervention effectiveness
  • Provide in-home testing kits for diabetic screenings
  • Telephonic outreach to members
     
 

 

To see UCare’s work on important past projects, such as the Opioid (New Users) Project, please visit the Collaborative Health Plan Performance Improvement Projects (PIPs) page on the Stratis Health Website.  

*Stratis Health is a non-profit organization with a mission to collaborate and improve health by guiding health improvement initiatives. Stratis Health facilitates and works with Managed Care Organizations (MCOs) such as UCare.