Hundreds of thousands of Rhode Islanders depend on United Health Plans of New England (UHPNE) for their health care insurance. The reason is that, in its short 15-year history, United Health Plans has built a reputation as an innovator in health care.
"We've been an agent of change, providing a whole new perspective in quality health care service" said Joseph A. Chazan, UHPNE chairman.
United Health Plans has made its mark by offering Rhode Island employers a sophisticated array of high quality health care plans for their employees at an affordable price.
While it is affiliated with United HealthCare Corp. in Minneapolis, Minn., UHPNE remains a local company. Its more than 300 employees are nearly 100 percent Rhode Islanders. It has agreements with about 4,500 physicians in its service area (Rhode Island, and central and southeastern Massachusetts).
And it works hard to justify its motto: "National leaders, neighborhood doctors." The company concentrates on local delivery of health care with a national headquarters for technology. This gives it access to many national treatment centers that a strictly local company would not have access to -- for instance, treatment for a Rhode Island heart patient could be arranged at the Mayo Clinic through the parent company.
UHPNE grew rapidly by becoming a leader in providing what the Rhode Island market wants -- quality services at a fair price. "This organization has never stayed put," says Robert Winston, director of public affairs. "We look at the needs of Rhode Island and adapt accordingly."
One indication of how well that policy has been received was the company's survey of customer satisfaction in which it received a favorable rating from 98 percent of its customers.
It has worked hard to justify its reputation as a member in good standing of the Rhode Island community. One illustration will serve to make the point:
In 1994, the state advertised that it needed a company to take over and run a program it called RIte Care, which it created to treat Medicaid patients in Rhode Island.
Patients who are uninsured are covered by Medicaid, which until recently was run by the federal government. In Rhode Island, Medicaid-eligible patients are usually single mothers and their children. Many states are losing money on Medicaid patients because, as a group, their health habits are difficult to manage.
So, when Rhode Island said it needed a company to manage its RIte Care program, only one company stepped forward. UHPNE agreed to treat the more than 35,000 patients in the RIte Care program for a fixed price, taking on a rather large risk. UHPNE's job now is to manage the behavior of RIte care patients and help them learn habits that benefit their own personal health.
UHPNE also has a SeniorCare Program for senior members. "These programs are a testament to our concern for ensuring all people access to basic medical care," said Dr. Chazan.
The firm began life in 1979 when a group of physicians in Kent County first discussed the concept of an alternative health insurer. Soon, 75 physicians had invested their own money in a new plan health maintenance organization (HMO) called the Ocean State Master Health Plan. It emphasized the preventive aspects of health care.
In 1983, its first year of operation, it earned just $355,000 in annual revenues that first year.
But in just two years, Ocean State, as it was called, had become the state's largest HMO and had changed its name to the Ocean State Physicians Health Plan. It had grown through its strategy of depending on a network of participating physicians for its services, giving it a tremendous competitive advantage over so-called staff model HMOs in the state.
Ocean State's enrollment increased so fast that, by 1989, its enrollment topped 115,000. New England Business magazine rated it the fast growing company in New England, and Inc. magazine ranked it number two on its list of the 500 fastest growing companies in the country.
In 1986, it hired United Health Management Co., a subsidiary of United HealthCare, as a manager. In 1991, United HealthCare bought a majority stake in the company. Two years later, Ocean State changed to its current name.
Managed care programs such as those offered by UHPNE may hold some of the answers to the current health care crisis. One person who believes that is Max Powell, president and CEO of UHPNE. "Unmanaged access to health care services will continue to generate unacceptable cost increases, while managed access can produce cost savings which may enable us to meet our objective of providing universal care," said Powell.
Powell is hopeful that the legislative process will come to the same conclusion, paving the way for a future in which managed care, operated by HMOs, can continue to offer competitive premiums for all without fear of federally mandated -- an unmanaged -- programs.