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Understanding the needs of
employers that are the health care providers
UMR has experience
working with more than 130 hospital and health system customers. From small
regional hospitals to large, multi-state integrated delivery systems, we help
plan sponsors provide quality health care to employees while effectively
managing employee productivity and plan costs. Not only that, we will work
with hospitals and health systems to maximize their return on existing
resources.
At
UMR, we provide maximum flexibility through customized benefit plans
administration to meet a hospital’s strategic objectives. Key areas of
expertise and flexibility include:
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Hospital experience
UMR effectively manages employee health benefits for over 130 hospital/health
care customers with 450,000 members across the United States
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Flexible model
We provide maximum flexibility that matches a customized benefits solution to a
hospital’s strategic objectives. Areas of flexibility include:
Networks
Our experience administering three- and four-tier networks along with access to
UnitedHealthcare’s national network and over 80 regional rental networks allows hospital systems to
maximize domestic utilization while effectively managing any non-domestic costs
. Other administrative utilities, such as domestic check suppression and
customized domestic provider reimbursements can be provided to further plan objectives and minimize
expense.
Health management services
We can “carve-out” or deliver health management programs based on the hospital systems
existing resources.
Pharmacy benefit managers
Depending on the hospital’s needs, clients can leverage our preferred pharmacy benefit
manager (PBM), eight other PBMs as well as a hospital’s own pharmacy services.
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Coordination with hospital to build a highly effective wellness programs
Our health and wellness program combines clinical health risk assessments,
predictive modeling and case selection to identify at-risk members, engages them through plan
design and empowers them with support from health educators in coordination with existing hospital
wellness resources.
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Customized reporting with benchmarks to support decision making
We leveraged our hospital customers to develop a unique hospital reporting package
that includes, among other things, detailed utilization information, “no-pay” reports and
hospital-specific benchmarks.
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Personalized service
Hospital clients have a designated team of
benefits professionals that are an extension of the human resources
department. Additionally, calls are answered via live CSR who pays
claims and answers phone calls promoting greater first call resolution and
high member satisfaction.
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