United Healthcare 2006 Annual Report Download - page 15

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Evercare
Through its Evercare division, Ovations is one of the nation’s leaders in offering complete, individualized care
planning and care benefits for aging, disabled and chronically ill individuals. Evercare serves approximately
124,000 people (including 53,000 with Medicare Advantage) across the nation in long-term care settings
including nursing homes, community-based settings and private homes, as well as through hospice and palliative
care. Evercare offers services through innovative care management and clinical programs.
Evercare integrates federal, state and private funding through a continuum of products from Special Needs Plans
and long-term care Medicaid programs to hospice care, and serves people in 35 markets in home, community and
nursing home settings. These services are provided primarily through nurse practitioners, nurses and care
managers. Evercare operated Special Needs Plans in 34 states as of December 31, 2006.
Evercare Solutions for Caregivers is a comprehensive eldercare service program providing service coordination,
consultation, claim management and information resources nationwide. Proprietary, automated medical record
software enables the Evercare clinical care teams to capture and track patient data and clinical encounters,
creating a comprehensive set of coherent care information that bridges across home, hospital and nursing home
care settings for high-risk populations. Evercare also operates hospice and palliative care programs in nine states
and intends to expand these products into at least five new markets in 2007.
Prescription Solutions®
Prescription Solutions offers integrated pharmacy benefit management (PBM) services (including mail order
pharmacy services) to approximately 6.6 million people, as of December 31, 2006. Prescription Solutions offers
a broad range of innovative programs, products and services designed to enhance clinical outcomes with
appropriate financial results for employers and members. The fulfillment capabilities of Prescription Solutions
are an important strategic component in serving PacifiCare’s legacy commercial and senior business, as well as
PacifiCare’s Part D enrollees. Effective January 1, 2007, Prescription Solutions began providing PBM services to
an additional four million Ovations Medicare Advantage and stand-alone Part D members.
AmeriChoice
AmeriChoice, through its affiliates, provides network-based health and well-being services to beneficiaries of
state Medicaid, Children’s Health Insurance Programs (CHIP), and other government-sponsored health care
programs. AmeriChoice provides health insurance coverage to eligible Medicaid beneficiaries in exchange for a
fixed monthly premium per member from the applicable state. AmeriChoice provides services to approximately
1.4 million individuals in 13 states. AmeriChoice also offers government agencies a broad menu of separate
management services — including clinical care, consulting and management, pharmacy benefit services and
administrative and technology services — to help them effectively administer their distinct health care delivery
systems and benefits for individuals in their programs. AmeriChoice also contracts with CMS for the provision
of Special Needs Plans serving individuals dually eligible for Medicaid and Medicare services. These programs
are primarily organized toward enrolling individuals who dually qualify for Medicaid and Medicare coverage in
states where AmeriChoice operates its Medicaid health plans.
AmeriChoice’s approach is grounded in its belief that health care cannot be provided effectively without
considering all of the factors — social, economic, environmental, and physical — that affect a person’s life.
AmeriChoice coordinates resources among family members, physicians, other health care providers and
government and community-based agencies and organizations to provide continuous and effective care. For
members, this means that the AmeriChoice Personal Care Model offers them a holistic approach to health care,
emphasizing practical programs to improve their living circumstances as well as quality medical care and
treatment in accessible, culturally sensitive, community-oriented settings. For example, AmeriChoice’s disease
management and outreach programs focus on high-prevalence and debilitating illnesses such as hypertension and
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