UPMC: Making Quality Care Simple

Last month, the National Committee for Quality Assurance 2015-2016 Health Insurance Plan Ratings awarded UPMC Health Plan 5 out of 5 for their Benefit Management Services and Health Coverage plans, making UPMC the highest-rated commercial plan in Pennsylvania.

Senior Medical Director Stephen E. Perkins, M.D., attributes UPMC’s high rating to its member-centric culture.

UPMC’s member services include its Health Care Concierge team, who are available six days a week by phone and around the clock via online message. The Health Care Concierge team comprises representatives able to provide information on patient benefits, providers, plans, prescriptions and more. According to Dr. Perkins, “UPMC provides members with a concierge one-stop shop for all their questions and inquiries.” Customers can call in, and representatives will ensure that their requests are fulfilled immediately, within the span of the phone call.

UPMC’s Health Care Concierge team is more than a resource for questions and concerns. Through the team, UPMC actively anticipates members’ care needs. Customer service representatives can access data tracking whether members have recently visited a physician or received particular information or services. While sensitive health information is managed and protected by specialized firewalls, all staff are able to check in on members, and even make outbound calls assuring that members are invested in their own health care.

UPMC also engages physicians and coordinates with them once a member comes in for an appointment, or once staff realize a member is overdue for care. The Health Plan Care team provides real-time information to physicians, ensuring that doctors are providing preventive and individualized care, while also working to foster healthy populations.

By making high-quality health care easily accessible to customers, UPMC is bolstering communication and bridging connections among physicians, patients and populations. As Dr. Perkins said, “We are an enhancement to member care—not getting in the way of that care.”


-Zoya Haroon