United Healthcare 2005 Annual Report Download - page 9

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Ovations Secure Horizons
The Ovations Secure Horizons division provides health care coverage for the seniors market primarily through
the Medicare Advantage program administered by CMS. Ovations offers Medicare Advantage HMO, PPO,
Special Needs Plans and Private-Fee-for-Service plans. Under the Medicare Advantage programs, Ovations
provides health insurance coverage to eligible Medicare beneficiaries in exchange for a fixed monthly premium
per member from CMS that varies based on the geographic areas in which members reside. Products are offered
under the Secure Horizons and UnitedHealthcare Medicare Complete brand names. In 2005, Ovations Secure
Horizons expanded its program to 16 new regional markets and offered Medicare Advantage in 35 markets
nationwide. In addition, Ovations Secure Horizons offers Private-Fee-for-Service plans in 24 states. As of
December 31, 2005, Ovations had more than 1.1 million enrolled individuals in its Medicare Advantage
products. Beginning January 1, 2006, Secure Horizons will offer a regional PPO in 3 markets.
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
80,000 people 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. In 2005, Evercare expanded its programs and now offers services in 23
states.
Evercare offers a variety of federally sponsored products that provide enhanced medical coverage to frail, elderly
and chronically ill populations in both nursing homes and community settings. These services are provided
primarily through nurse practitioners, nurses and care managers. Evercare also offers a Medicaid long-term
health care product for elderly, physically disabled and other vulnerable individuals in five states. Evercare
Connections is a comprehensive eldercare service program providing service coordination, consultation, claim
management and information resources nationwide. Proprietary, automated medical record software enables
Evercare geriatric care teams to capture and track patient data and clinical encounters in nursing home, hospital
and home care settings. Evercare has begun extending its complex care management services to end-of-life
situations and now offers community-based hospice programs in four states.
AmeriChoice
AmeriChoice 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 through its
affiliates. 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 nearly
1.3 million individuals in 13 states across the country. The individuals AmeriChoice serves generally live in
areas that are medically underserved and where a consistent relationship with the medical community or a care
provider is less likely. The population served by AmeriChoice also tends to face significant social and economic
challenges. AmeriChoice 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 for individuals in these
programs.
AmeriChoice’s approach is grounded in its belief that health care cannot be provided effectively without
consideration of all of the factors—social, economic and environmental, as well as 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. AmeriChoice’s disease management
and outreach programs focus on high-prevalence and debilitating illnesses such as hypertension and
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