Dr. Marigene Hartker, East Regional Chief Medical Officer, Employer & Individual Health plans, UnitedHealthcare

In an interview with Invest:, Dr. Marigene “Mimi” Hartker, East Regional Chief Medical Officer, Employer & Individual Health plans for UnitedHealthcare, talked about key achievements, including the implementation of digital tools like Point of Care Assist and Surest to empower people to shop for care and make choices that are right for them with the goal of improving the health care experience. UnitedHealthcare focuses on empowering providers and consumers through technology and data-driven solutions, addressing diverse generational needs and improving patient care with innovations that support whole person health and help lower the total cost of care. 

How would you say the last year has gone in terms of achievements and milestones? 

At UnitedHealthcare, our focus on innovation is driven by the needs of the people we serve. As consumers demand more from their health care experience, it fundamentally changes the way people engage with the health system overall. UnitedHealthcare aims to help them access the care they need, when they need it, at an affordable cost. This requires continued collaboration, innovation, and new approaches. While the health care system can often seem complex, costly and difficult for the consumer to fully understand, we are constantly looking for ways to help address these challenges. Our software interface called Point of Care Assist guides the consumer to the most appropriate and low-cost setting. It is integrated into a provider’s workflow and gives real-time cost information to our providers for lab radiology and specialty referrals. It also allows them to look at medications and see the copay specifically for that patient so they can see within a class of drugs which would be the most affordable, effective option.

Can you provide an overview of the growth opportunities within the healthcare sector in Orlando and Central Florida? 

UnitedHealthcare offers an innovative health plan called Surest that empowers the consumer to shop for health care services to make decisions that are right for them based on their needs. 

Unlike traditional plans, Surest eliminates deductibles and coinsurance. Instead, members pay only a copay, which may vary depending on the service and provider they choose. All providers in the network are evaluated based on historical performance data, including effectiveness and cost-efficiency criteria. Those that performed better are deemed higher value. Members can use the Surest website or app to see available care options, in-network providers and the cost of the service or procedure they need, with lower copays for higher-value care providers.

Surest can help improve access while lowering costs. One thing we’ve seen is that Surest members are able to use the Surest app to find affordable care that meets their needs. For example, we have seen a 30% increase in telehealth utilization for Surest members. Advancing technology in a way that makes sense for the consumer is important to us because it allows us to deliver innovative tools and services, like Surest.

How have client expectations changed in recent times and how are you adapting? 

UnitedHealthcare serves a diverse population of members across generational divides, and we want to deliver experiences and solutions that help them live healthier lives. As an example, Millennials may want their information based on the latest technology while a Gen-Xer (like me) may prefer face-to-face meetings with their providers – or vice versa. That’s why UnitedHealthcare is focused on delivering solutions that serve the broad, individual needs of the tens of millions of people we serve.

How are you leveraging technology to provide better services? 

We talked about a few solutions already like the Surest health plan and Point of Care Assist but another way that we excel is in our case management programs. These programs may involve nurses, physicians and other clinical people who can work with members to help manage chronic conditions like type 2 diabetes with the goal of improving their overall health and wellbeing, improving access, and lowering their total cost of care. We do this as a way to improve the patient’s care. Another example is UnitedHealthcare’s Level2 program. 

Level2 is a value-based care solution that combines wearable technology with customized clinical support and aims to help improve the health of people living with type 2 diabetes.

It is grounded in metabolic and behavioral science and equips eligible participants with continuous glucose monitors (CGM) and personalized support from a care team to help encourage healthier lifestyle decisions, like food choices, exercise and sleep patterns.

Through the Level2 Assured Value Program, eligible employers with more than 125 covered employees with type 2 diabetes will have 100% of program fees reconciled against actual medical and pharmacy claims savings. If actual value generated is less than paid program fees, Level2 gives back the difference to eligible employers.

Level2 aims to center the care experience around eligible members with type 2 diabetes, while offering employers a tool that can help bend the cost curve of treating these employees.  

What are some of the main challenges in the healthcare sector at the moment? 

Managing cost of care continues to be a challenge for everyone in the health care business. We continue to work diligently to ensure our members have access to affordable care. Keeping overall cost of care down by closing gaps in care and focusing on whole person health helps everyone save in the long term. Point of Care Assist is one way we do that.

What are your main priorities and plans over the next two to three years? 

UnitedHealthcare’s benefits and solutions are on the cutting-edge, in my opinion, and we value innovation. We will continue to put the consumer first because they help drive health care more and more, especially with increasing cost pressures. As the consumer becomes more knowledgeable about their health care choices and able to make educated decisions, we want to be at the forefront with technology and products that allow them to do that quickly and painlessly. Our scale and insights enable us to see the whole picture and help us better serve our members and customers. We are poised to make a big difference in helping create a future where everyone has access to high quality, affordable healthcare.