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

Business Wire, July 9, 1996

CHICAGO--(BUSINESS WIRE)--July 9, 1996--United HealthCare of Illinois, 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 market while controlling costs," said Marshall 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, as their personal physician, and may change physicians at any time. An out-of-network 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 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 -- formerly MetraHealth Care Plan of Illinois, Share Health Plan of Illinois and Chicago HMO -- 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 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 health care company by Fortune magazine's annual survey.

CONTACT: Golin/Harris Communications

Jorge del Mazo, 312/836-7164

Paula Wheeler, 312/836-7189