United Healthcare is a health management organization present in the US. They have
years of operation and experience in the healthcare field. They have also grown their
organization significantly. However, they still have the potential to expand further and develop
their services. This paper will describe United Healthcare and its overall readiness. It will also
prepare a strategic plan to address current and potential issues in the organization. It will also
propose a model that can be used to support the implementation of the strategic plan and the
rationale for the model. United Healthcare can potentially expand and resolve internal and
external issues through a strategic plan that involves the use of the patient-centered care
framework.
United Healthcare is the country’s largest healthcare insurance provider (Gale, 2014). It
provides national health care management services in the US. It was founded in 1974 and used to
serve different segments of the health care market (Peterson, Shatin & Mccarthy, 1996). United
Healthcare was the one who initiated the development of methods and systems of a managed
care setting approach. This was done through the development of Quality Screening and
Management. Furthermore, this eventually led to the establishment of the Center for Health Care
Policy and Evaluation, which evaluates and enhances the cost, quality, and access to health
services.
United Healthcare is ready to meet the healthcare needs of citizens in the next decade.
Due to decades of being in the health management services, United Healthcare has a
comprehensive and credible database about medical claims, pharmacy data, patient records, and
treatment history of the millions of members during the years of their enrollment to the managed
care plan (Peterson, Shatin & Mccarthy, 1996). United Healthcare has the most comprehensive
medical records and treatment information that can be collected in the health care system. The
HEALTH ORGANIZATION EVALUATION 3
organization also has a comprehensive database of provider information throughout the US. The
database of United Healthcare can help in studying trends and techniques that can help deliver
high-quality and efficient care. The database has an informational value that can benefit both the
insurer and the patient (David, Saynisch & Smith-McLallen, 2018). This would also help
overcome barriers to optimize the delivery of health services.
The recommended strategic plan for United Healthcare is the Patient-Centered Care Plan
(Ho, 2015). The primary strategy is to track patients with high-risk conditions. Interventions will
be done to prevent adverse events and re-engage these patients in a regular healthcare
consultation. This would reduce inpatient admissions and emergency visits. A partnership with
the local community and local care organizations is also initiated to ensure that behavioral and
social support is coordinated and provided.
One of the issues that United Healthcare has faced and could be facing in the future is the
removal of thousands of physicians from the health care coverage plan. This has earned and may
earn reactions from national specialty societies, medical associations, and several state lawyers.
The termination of the physicians was due to the budget cutback of the government on Medicare
Advantage (Gale, 2014). A reduced budget means that United Healthcare also needs to cut costs
through the termination of physicians from the coverage plan. A similar issue can put a strain on
the reduced number of healthcare professionals who can provide the patient-centered care plan
for all members of United Healthcare.
The patient-centered care framework is the proposed model for the strategic plan (Ho,
2015). This focuses on primary care, which allows the provision of care in a single place, which
is usually the patient’s home. The model attempts to reduce emergency visits and admissions
through directly addressing assessed health care needs and preventing adverse events related to
HEALTH ORGANIZATION EVALUATION 4
healthcare conditions. Data on population groups with the most health care visits can also be
used to identify home care and public health education aimed towards evidence-based prevention
of disease and promotion of wellness. For example, based on the data from Table 1, United
Healthcare can focus on promoting home care for institutionalized and adult patients due to their
high utilization of health services. Moreover, community care for maternal and adult patients can
also help reduce healthcare spending for thes