United Physicians provides its members with health plan administrative support and discount purchasing programs including:

• Negotiating health plan contracts under the messenger model.
• Credentialing and recredentialing.
• Planning enrollment and practice changes and/or updates.
• Educating and informing members regarding changes in health plan reimbursement, fee schedules, incentive programs or medical management requirements such as authorizations and/or referral.
• Group discount contracts with suppliers/vendors.
  • Vaccine purchasing program through Merck, Sanofi Pasteur and Pfizer.
  • Discount office supplies through Staples.

United Physicians participates in, and provides practice-level support for the following health plan initiatives and incentive programs.

• Blue Cross Blue Shield of Michigan (BCBSM) Physician Group Incentive Program (PGIP) – Develop and carry out implementation plans for utilization and quality initiatives.
• BCBSM Patient-Centered Medical Home (PCMH) – Develop and carry out implementation plans for 12 initiatives associated with highly functioning and clinically sound practices.
• HMO Quality Performance Incentive programs – Educate and support practices in order to improve performance in quality metrics, and provide information on HMO medical management programs.
• Organized System of Care (UPIC) – United Physicians is creating a patient-centered network of physicians, health systems and ancillary providers dedicated to delivering the highest quality, most cost-effective care in Southeastern Michigan.

United Physicians’ Medical Management Team works collaboratively with physicians to identify improvement opportunities in clinical practice that result in better patient care, a strong referral base, and increased payer incentives.

• Care management services provided by nurses, dietitians, diabetic educators, and social workers to improve the health of your patient population.
• Practice level and individual physician level review of clinical data, and interpretation of health plan reports for assessment of performance compared to peers.
• Facilitation of physician led action groups within each specialty that share best practice, and improve coordination of care.
• Access to patient education materials and valuable clinical resources such as evidence-based clinical guidelines, and clinical decision support.

UP takes information received from multiple payers and condenses it into a usable format that is actionable. On a regular basis, members receive reports through the secure UP Portal on financial success, cost and utilization efficiency, quality and gaps in care. Reports are helpful in identifying areas where you excel, opportunities for improvement and comparisons to your peers and industry benchmarks. Your dedicated practice transformation specialist is trained to help you use the information in your reports to make recommendations to improve your overall performance.

United Physicians has a Practice Transformation Team that supports our practices in the following areas:

• Provide support and educational information for physicians participating in managed care plans in order to enable success in pay-for-performance and other quality based incentive programs.
• Practice-level support to enable practices to participate and be successful in the BCBSM Physician Group Incentive Program (PGIP).
• Provide face-to-face support to achieve and maintain BCBSM’s Patient-Centered Medical Home (PCMH) designation.
• Support eligible practices/physicians in achieving financial gain in the BCBSM specialist uplift program.

Health Information Technology (HIT) is becoming increasingly important in regards to communication between providers, transitions of patient care, and general practice operations.

Every UP shareholder is assigned a UP Portal account as a benefit of membership. Ongoing training and support, including a dedicated help desk, make using the portal simple.

The secure portal offers:

• Admissions and Discharges Viewer
• Clinical applications
• Physician Finder – A UP Physician Directory
• My Practice – a dedicated practice file repository
• A resource library to assist practices with patient care

Practices have access to a real-time facility census of patients admitted to local area hospitals. Other patient-centric information from various sources, including past medical encounters, lab results, pathology and radiology reports and medications can also be fed from multiple plans and systems into UP’s datawarehouse.