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Quality highlights

Quality matters at UCare

UCare is a health plan in Minnesota and western Wisconsin. UCare serves:

  • Individuals and families choosing insurance through MNsure and the insurance marketplace in 77 counties
  • Medicare-eligible individuals in all 87 counties
  • Individuals and families enrolled in Minnesota health care programs, such as MinnesotaCare and Medical Assistance in 44 counties
  • Adults with disabilities in 67 counties

Our Quality programs continue to see positive outcomes as we support and improve our members' health.

Our programs


 

2024 Star Ratings

Every year, the Centers for Medicare & Medicaid Services (CMS) measures and awards plans based on a 5-star rating system, five stars being the highest. These Star Ratings are awarded each year and may change from one year to the next.

Current Star Ratings:

  • UCare Medicare – 4.5 out of 5 stars
  • UCare's Minnesota Senior Health Options – 4 out of 5 stars
  • UCare Connect + Medicare – 3.5 out of 5 stars
  • EssentiaCare – 4.5 out of 5 stars
  • UCare Individual & Family Plans – 4 out of 5 stars
  • UCare Medicare with M Health Fairview & North Memorial – 3.5 out of 5 stars

Why do Star Ratings matter?

Star Ratings can be used as a tool to tell which plans in your area are top performers. A plan with a 4-star rating or higher is considered an above-average plan. You can use these Star Ratings to compare our plan’s performance to other plans and find the one that best meets your needs. You can look up Medicare plans and review their ratings at medicare.gov. For Individual & Family Plans, visit mnsure.org

How can I enroll in UCare's high-performing star plans?

To learn more, schedule a call with a licensed Medicare sales specialist by calling 612-676-3500 (TTY users call 612-676-6810 or 1-800-688-2534).

Hours of operation:
8 am – 8 pm, seven days a week (Oct. 1 – March 31)
8 am – 8 pm, Monday – Friday (April 1 – Sept. 30)


 

NCQA Accreditation

NCQA is a private, non-profit organization dedicated to improving health care quality. NCQA’s website contains information to help consumers and others make more informed health care choices.

NCQA Health Plan Accreditation badge

Health Plan Accreditation

UCare’s full line of Medicare, Medicaid and Individual & Family health plans maintain Health Plan Accreditation from the National Committee for Quality Assurance (NCQA). This accreditation shows that UCare is committed to the highest standards of quality.

NCQA Health Equity Accreditation badge

Health Equity Accreditation

UCare’s Medicaid plans achieved Health Equity Accreditation from NCQA. This accreditation recognizes UCare as a market leader providing services sensitive to members’ cultural and language preferences in addition to working to reduce health inequities and improve care.

 

Learn more about our Quality programs

Every year, UCare reviews the work from last year and sets new goals for this year.

Quality Management Program Description 2023
Quality Management Program Evaluation Executive Summary 2022
Quality Management Program Work Plan 2023


 

Member satisfaction

Member feedback is important to UCare — we want to hear from you. The Centers for Medicare & Medicaid Services (CMS) and Department of Human Services (DHS) measures UCare’s overall performance as a health plan through yearly member experience surveys. The surveys help health plans identify opportunities to improve quality and services and help CMS and DHS monitor the performance of these plans.

We hope you are satisfied with your plan and willing to share your experience with us. If for any reason you are unhappy with our service, let us know by calling the customer service number on the back of your member ID card or send a secure message through your online member account.

UCare scored above the national average on several 2023 member satisfaction measures. UCare identified the following focus areas and improvement opportunities for 2024:

Focus area Improvement opportunities
Customer service
  • Focus on delivering excellent customer service to our members and build member trust
  • Continue to train customer service staff on active listening and resolution skills to improve member experience
Rating of health plan
  • Continue diverse member outreach including phone calls, member mailings, emails and creating a community presence
  • Continue to partner with community service providers to improve member health outcomes and health equity
Rating of drug plan 
  • Review the list of covered drugs (formulary), member feedback and internal data to better understand the prescription drug needs of our members
  • Improve member communication of drug list changes
  • Ability to connect with a UCare pharmacist to answer drug list questions


 

UCare's Quality Improvement initiatives

UCare wants to continually improve our products and operations to provide you with the highest quality of care. UCare looks at performance data and member experience feedback to identify where we can make improvements. We ask members and community partners to help us develop programs and activities that improve health, lower costs and reduce health gaps. Improvement activities are assessed to make sure they are helping us achieve our goals. We've highlighted a few key activities as part of our mission.

Making it easier for you to see a dentist

This project promotes oral health and the importance of yearly dental visits for children and families.

For UCare members with: 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), Prepaid Medical Assistance Program (PMAP)

Goal: To increase the number of members that visit a dentist every year

 For members What we do For providers
  • Train and teach our care coordinators
  • Provide services from our health improvement specialists related to dental care that aligns with members’ background and language preferences
  • Connect members and providers to dental care coordinators
  • Make it easier to get four cleanings per year
  • Add benefits for MSHO and Connect + Medicare like cleanings and crown replacement

If you need help finding or locating a dental provider, please call UCare Dental Connection at 651-768-1415 (TTY users call 711) or 1-855-648-1415 (toll free), from 7 am – 7 pm, Monday – Friday or contact customer service.

The dental table shows results from 2020 – 2022 trended data.

Annual Dental Visit Rate 2020 2021  2022
MinnesotaCare  24.45% 27.81%  26.63%
PMAP 30.87% 35.50%  45.71%
Connect/Connect + Medicare 36.82% 34.58%  38.22%
MSHO/MSC+ 24.20% 32.17%  33.37%


 

Current performance improvement projects (PIP):

UCare works with other Minnesota health plans and the Department of Human Services (DHS) to improve the health of Minnesotans.

Healthy Start for Mothers and their Children

This project promotes a “Healthy Start” for Minnesota mothers and their children, particularly those with the most significant racial and ethnic gaps.

For UCare members with: Prepaid Medical Assistance Program (PMAP), MinnesotaCare

Goal: To provide timely prenatal and postpartum care to our members, increase well-child visits, encourage childhood vaccines and decrease health gaps

for members  what we do for providers
  • Are you pregnant? Get connected with UCare’s resources and support by calling the customer service number on the back of your ID card
  • Earn rewards for completing your pregnancy and well-child visits with UCare member incentives
  • Learn more about our MOMS Program to help you stay healthy during and after pregnancy
  • Learn how to get a free car seat by calling UCare Customer Service to be connected with a SEATS Program partner
  • Find resources and ideas for planning and preparing healthy foods, such as food assistance, meal planning, recipes and more from our food and nutritional resources
  • Case management for members' prenatal and postpartum care
  • Provide services from our health improvement specialists related to preventive care that aligns with members’ background and language preferences
  • Community-based engagement and provider partners
  • Review our benefits to ensure members have access to needed services during pregnancy

In the tables for maternal health, UCare has calculated trending data for each of the measures and drill-down analysis on health care gaps.

Maternal health measures:

  HEDIS MY 2020 HEDIS MY 2021  HEDIS MY 2022
Overall rates  
Family and children 73.02% 54.57%  56.5%
Race  
Black, Indigenous and people of color 78.13% 57.84%  58.8%
White/Caucasian 67.67% 51.35%  53.0%
Geographic location  
Metro 77.25% 59.82%  62.2%
Rural 61.80% 41.29%  40.8%

  HEDIS MY 2020 HEDIS MY 2021  HEDIS MY 2022
Overall rates  
Family and children 46.35% 54.76%  54.1%
Race  
Black, Indigenous and people of color 43.40% 49.05%  50.3%
White/Caucasian 51.00% 57.01%  58.1%
Geographic location  
Metro 47.97% 51.56%  52.8%
Rural 51.27% 56.98%  57.8%

Childhood measures:

  HEDIS MY 2020 HEDIS MY 2021 HEDIS MY 2022 
Overall rates  
Family and children 36.34% 47.26%  38.5%
Race  
Black, Indigenous and people of color 30.02% 41.94%  37.4%
White/Caucasian 29.31% 53.19%  38.9%
Geographic location  
Metro 37.12% 47.19%  42.5%
Rural 33.56% 45.86%  26.9%

  HEDIS MY 2020* HEDIS MY 2021  HEDIS MY 2022
Overall rates  
Family and children -- 59.63%  56.8%
Race  
Black, Indigenous and people of color -- 56.85%  53.3%
White/Caucasian -- 65.10%  60.0%
Geographic location  
Metro -- 59.66%  58.0%
Rural -- 59.59%  53.8%

 

*The W30 measure was added to HEDIS in MY2021 and will be reported for the remainder of the project.

  HEDIS MY 2020 HEDIS MY 2021  HEDIS MY 2022
Overall rates  
Family and children 37.94% 34.80%  32.2%
Race  
Black, Indigenous and people of color 27.36% 26.00%  23.7%
White/Caucasian 41.98% 45.50%  40.7%
Geographic location  
Metro 34.37% 33.93%  31.1%
Rural 38.51% 36.90%  35.1%

Improving diabetes care

This project is to improve diabetes care and services with a focus on members with health care gaps. Race or ethnicity, sex, sexual identity, age, disability, socioeconomic status and geographic location all contribute to a person’s ability to achieve good health.

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

Goal: To improve diabetes care for members

 For members What we do For providers
  • Find resources and ideas for planning and preparing healthy foods, such as food assistance, meal planning and recipes and more from our food and nutritional resources
  • Explore how you can take an active role in managing your diabetes. Check out UCare Diabetes Disease Management Program.
  • Participate in our complete fitness program, One Pass, with access to more than 23,000 participating fitness locations
  • Improve community outreach and partnerships
  • Create tools to connect members to social services and community resources
  • Improve provider partnerships
  • Provide services from our health improvement specialists related to diabetes care that aligns with members’ background and language preferences
  • Use data to assess member social determinants of health risks to better understand barriers to care
  • Provide in-home testing kits for diabetic screenings 

In the tables demonstrated, UCare calculated trending data for each measure and a drill-down analysis on health care gaps. The 2020 – 2022 HEDIS rates are reported based on the comprehensive diabetes care (CDC) measure set. UCare will continue member education, outreach and work with providers to help us reach our goal. Also, efforts will continue with a focus on aligning care with member’s background and addressing gaps in care within the populations experiencing a disparity.

  HEDIS MY 2020 HEDIS MY 2021  HEDIS MY 2022
Overall HEDIS rates  
Connect 89.3% 92.7%  90.5%
Connect + Medicare 92.5% 94.9%  93.7%
MSC+ 78.8% 85.7%  **
MSHO 88.1% 94.6%  94.6%
Race  
Native American ** **  88.2%
Asian or Pacific Islander  81.3% 89.8%  95.4%
Black or African American 83.7% 88.3%  89.6%
People of color 82.9% 88.8%  91.1%
White/Caucasian 86.7% 90.6%  94.2%
Geographic location  
Metropolitan 84.5% 89.3%  93.1%
Micropolitan 86.2% 93.0%  90.9%
Rural 83.9% 83.9%  95.0%

  HEDIS MY 2020 HEDIS MY 2021  HEDIS MY 2022
Overall HEDIS rates  
Connect 68.1% 70.1%  59.9%
Connect + Medicare 71.8% 771%  72.0%
MSC+ ** **  **
MSHO 59.4% 70.7%  66.7%
Race  
Native American ** **  70.6%
Asian or Pacific Islander  54.5% 64.8%  62.6%
Black or African American 53.3% 64.4%  58.7%
People of color 53.6% 64.6%  61.1%
White/Caucasian 74.3% 78.2%  69.5%
Geographic location  
Metropolitan 65.0% 71.2%  64.7%
Micropolitan 76.7% 81.1%  72.1%
Rural 72.6% 74.2%  72.0%

  HEDIS MY 2020 HEDIS MY 2021  HEDIS MY 2022
Overall HEDIS rates  
Connect 62.5% 60.1%  64.7%
Connect + Medicare 69.1% 72.0%  77.1%
MSC+ 57.6% 58.5%  **
MSHO 76.4% 74.4%  81.8%
Race  
Native American ** **  76.5%
Asian or Pacific Islander  57.5% 55.1%  73.3%
Black or African American 61.7% 62.0%  71.5%
People of color 60.3% 59.4%  72.6%
White/Caucasian 67.2% 66.8%  75.7%
Geographic location  
Metropolitan 63.7% 62.9%  74.1%
Micropolitan 69.3% 62.9%  80.5%
Rural 57.0% 58.0%  70.0%

  HEDIS MY 2021  HEDIS MY 2022
Overall HEDIS rates  
Connect 25.9%  25.4%
Connect + Medicare 32.7%  34.9%
MSC+ 29.9%  27.8%
MSHO 33.8%  35.8%
Race  
Native American 21.7%  20.2%
Asian or Pacific Islander  33.5%  28.8%
Black or African American 35.0%  36.1%
People of color 33.3%  32.4%
White/Caucasian 25.4%  27.4%
Geographic location  
Metropolitan 28.6%  29.0%
Micropolitan 33.7%  34.5%
Rural 30.5%  31.4%

 

**For geographical location and race, results with denominators less than 30 or numerators less than 10 were suppressed due to rate instability from small numbers. For MSC+, it was not a reportable product for UCare.

To see more of UCare's work on important current and past projects, visit Stratis Health's Collaborative Health Plan performance improvement projects webpage.

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