Colorado Doctor’s Plan: Designed to help break down barriers and save members money

Who knows you and your health care needs better than your own doctor? In 2017, UnitedHealthcare of Colorado recognized that including physicians in the development of a health coverage plan seemed to be a missing piece of the health insurance puzzle. What was born from the collaboration is now known as the Colorado Doctor’s Plan

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The plan, a partnership between UnitedHealthcare of Colorado and Centura Health, offer members primary care, urgent care and telemedicine visits at zero co-pay, plus drug cost-transparency and new technologies to help members navigate the health care system. After being introduced to clients across eight counties around Denver and the Front Range in 2019, it has quickly gained a toehold in new membership in 2020.

“We recognized that things had to change,” Marc Neely, CEO of UnitedHealthcare of Colorado. “Health care costs were and still are too high and the system is too complicated. So, we asked, ‘If we could build a better solution from the ground up, with consumer and physician satisfaction as job No. 1, what would that look like?’”

Today, through the Colorado Doctors Plan, UnitedHealthcare and Centura jointly offer not just primary care, urgent care and telemedicine visits, but also:

  • personalized welcome calls to new enrollees to explain benefits, transfer prescriptions, select a primary care doctor and help identify health issues that may need immediate attention;
  • new opt-in mobile technology that alerts the plan when a member arrives at an emergency room so lower out-of-pocket care options can be shared, if appropriate.

For physicians, the value of the Colorado Doctors Plan lies in the vast amount of health data available that may help improve patient outcomes. For example, preferred drug lists are now imbedded in the doctors’ electronic medical records system. This can help make it easier to have in-office conversations with patients about drug costs, efficacy and coverage, so there are no surprises when the patient arrives at the pharmacy.

The ability to have these upfront discussions can result in less frustration for patients and doctors.

“Creating this plan challenged hundreds of people to look beyond the legacy limitations in our information systems, our contracting, our finances and almost every functional area of the business to create a new framework for working with care providers that didn’t really exist before,” Marc said.

The effort has also sparked interest from other states, all of which are developing their own version of the Doctors Plan.

“We’re really living out our mission of making health care more affordable and simpler for everyone,” Marc said. “That’s good for patients and it’s good for doctors, too.”