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United HealthCare of Illinois introduces unique, no-referral managed care plan; 'Open Access' gives consumers more choice.


CHICAGO--(BUSINESS WIRE)--July 9, 1996--United HealthCare of Illinois Illinois, river, United States
Illinois, river, 273 mi (439 km) long, formed by the confluence of the Des Plaines and Kankakee rivers, NE Ill., and flowing SW to the Mississippi at Grafton, Ill. It is an important commercial and recreational waterway.
, Inc. today announced the introduction of Open Access, the first no-referral managed care plan of its kind in Illinois. Open Access, available to Chicago-area businesses on Aug. 1, 1996, is an innovative plan that gives members the option of going directly to in-network specialists without obtaining referrals from primary care physicians.

"The introduction of this new health service product signifies our continued commitment to delivering quality care in the Chicago Chicago, city, United States
Chicago (shĭkä`gō, shĭkô`gō), city (1990 pop. 2,783,726), seat of Cook co., NE Ill., on Lake Michigan; inc. 1837.
 market while controlling costs," said Marshall Marshall.

1 City (1990 pop. 12,711), seat of Saline co., N central Mo.; inc. 1839. In a large farm area, it is a processing center for grain, eggs, meat, and dairy products. Marshall is the seat of Missouri Valley College.
 V. Rozzi, chief executive officer of United HealthCare of Illinois. "A top demand from existing and potential managed care plan members is the freedom to see the doctors they want to see, when they want to see them. The Open Access plan answers that demand, while preserving the cornerstones of managed care such as cost savings and coordinated patient care."

Open Access allows plan members to choose among a broad network of participating physicians -- including specialists -- without a referral. A member may choose any network physician, including an OB/GYN OB/GYN A common abbreviation for obstetrics and gynecology , as their personal physician, and may change physicians at any time. An out-of-network out-of-network Managed care adjective Referring to a provider/service that is not part of an MCO's network of contracted providers/services. See Managed care organization.  option is also a part of the Open Access plan. This gives members the option to seek care outside the provider network (out-of-network services are covered at a lower benefit level, except for emergency care, which is covered at full benefit levels).

The Open Access plan covers prescriptions, office visits, hospital services and preventive care Preventive care is a set of measures taken in advance of symptoms to prevent illness or injury. This type of care is best exemplified by routine physical examinations and immunizations. The emphasis is on preventing illnesses before they occur. See also
  • Public health
 with minimal copayments, and without deductibles or paperwork hassles if network providers are used.

The no-referral managed care plan concept was developed by United HealthCare Corp., United HealthCare of Illinois' parent company, more than a decade ago. This means that UHCI UHCI Universal Host Controller Interface  -- formerly MetraHealth Care Plan of Illinois, Share Health Plan of Illinois and Chicago HMO HMO health maintenance organization.

HMO
n.
A corporation that is financed by insurance premiums and has member physicians and professional staff who provide curative and preventive medicine within certain financial,
 -- draws from the resources and experience of a company with more than 20 years of health care management experience and more than 10 years of operating open access managed care plans. United HealthCare currently operates such plans in 15 other states.

Through market research, United HealthCare has found that more than 85 percent of consumers feel that it is important for them to directly access a specialist to receive medical services.

United HealthCare employs sophisticated management information systems that allow the company to offer open access plans while controlling costs. The systems track patient usage patterns and ensure that physicians file claims data before they are reimbursed.

Rozzi said that no-referral managed care plans "redefine Verb 1. redefine - give a new or different definition to; "She redefined his duties"
define, delimit, delimitate, delineate, specify - determine the essential quality of

2.
 managed care by empowering members to make health care decisions. Our model works by sharing intelligence with all physicians, not just primary care physicians, to raise the bar on quality -- but not on costs."

United HealthCare, one of the nation's largest health care management service companies, serves more than 40 million Americans and 45 of the nation's Fortune 100 companies through its broad range of health care management products and services. For the second year in a row, United HealthCare has been ranked as the nation's most admired ad·mire  
v. ad·mired, ad·mir·ing, ad·mires

v.tr.
1. To regard with pleasure, wonder, and approval.

2. To have a high opinion of; esteem or respect.

3.
 health care company by Fortune magazine's annual survey.

CONTACT: Golin/Harris Communications

Jorge del Mazo, 312/836-7164

Paula Wheeler, 312/836-7189
COPYRIGHT 1996 Business Wire
No portion of this article can be reproduced without the express written permission from the copyright holder.
Copyright 1996, Gale Group. All rights reserved. Gale Group is a Thomson Corporation Company.

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Publication:Business Wire
Date:Jul 9, 1996
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