Overview of UCare Quality Initiatives

Active Initiatives

 

The goals of Performance Improvement Projects (PIPs) and Quality Improvement Projects (QIPs) are to:

Improve health outcomes, member satisfaction, and identify best practices. 

Assess and improve clinical and administrative processes. 

Meet or exceed the quality-related requirements for CMS, MDH, DHS and NCQA. 

Collaborate on a targeted topic with other Managed Care Organizations. 

Implement interventions for improved health outcomes over a broad population of Medicare and/or Medicaid beneficiaries.

Elimination of Race and Ethnic Disparities in the Management of Depression (2015-2017) | Project Overview
 
Webinar: Providing Mental Health Services to Latinos | Tuesday, February 28, 2017 | 12:00-1:00 pm    
Webinar: Cultural Competency in Antidepressant Management   | Tuesday, July 14, 2015 | 12:00-1:00 pm
Webinar: Shared Decision-Making & Depression Treatment in Primary Care | Thursday, November 12, 2015 | 12:00-1:00 pm
 
Increasing Follow-up after Hospitalization Rates in the Special Needs Basic Care Population (2015-2017) |  Project Overview
 
SNBC Dental Access Improvement Project (2017-2020)

Improving Antidepressant Medication Management in the Senior Population (2016-2018) | Project Overview

Provider Tips for how to improve HEDIS (Healthcare Effectiveness Data and Information Set) scores.

UCare is committed to helping providers work with UCare members who face decisions regarding next steps in their care. In the coming months, we will be implementing a program to work with providers and our members to help build shared patient-centered decision-making into provider-patient interactions.
 
The Informed Medical Decision Making Foundation describes shared decision-making as such:
 
  • Shared decision making (SDM) is a collaborative process that allows patients and providers to make health care treatment decisions together, taking into account the best scientific evidence available, as well as the patient’s values and preferences.
  • SDM honors both the provider’s expert knowledge and the patient’s right to be fully informed of all care options and the potential harms and benefits. This process provides patients with the support they need to make the best individualized care decisions, while allowing providers to feel confident in the care they prescribe.
 
One of the resources UCare shared with our members is a webpage titled My Health Decisions, available for them through UCare’s website. This useful content from the Informed Medical Decision Making Foundation will help patients understand a wide range of health conditions—from low back pain to cancer—so they make informed decisions about their care options.
 
Shared Decision Making Resources:
 

UCare Implements New Transportation Management Software

UCare has rolled out a new transportation system to schedule rides for our members. The new service will continue to be called UCare HealthRide.

 

Read the June 22 Provider Bulletin.

 

 

 

 

 

As UCare implements the new claims system, you may have questions. Please see the most common questions below before contacting UCare for additional assistance. New questions will be added as they arise, so check back frequently.

Which Payor ID should be used for claims in 2019 vs. 2020?

The chart below indicates which Payor ID should be used for each UCare plan based on the claim date of service (DOS). The items in Red show which plans changed Payor IDs from 2019 to 2020:

Product

2019 DOS Payor ID

2020 DOS Payor ID
UCare Individual & Family Plans 55413 55413
UCare Individual & Family Plans with M Health Fairview 55413 55413
UCare Medicare Plans 52629 55413
EssentiaCare 52629 55413
UCare Medicare with M Health Fairview & North Memorial Health 52629 55413
UCare Connect + Medicare 52629 52629
UCare Connect 52629 52629
UCare - Minnesota Senior Health Options (MSHO) 52629 52629
UCare - Minnesota Senior Care Plus (MSC+) 52629 52629
UCare - MinnesotaCare (MnCare) 52629 52629
UCare - Prepaid Medical Assistance Program (PMAP) 52629 52629