UnitedHealthcare Global’s Isapre Banmédica Receives Award for Improving Care Management in Latin America

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Evidence-based care guidance helped decrease hospital length of stay and increased collaboration with hospital providers.

MCG Health

MCG Health, part of the Hearst Health network, produces evidence-based, clinical guidance used by nearly 2,000 hospitals and nine of the largest U.S. health plans.

Using evidence-based guidelines as a foundation, we focus on improving the quality of care for those we serve. That reduces unnecessary health care costs and allows more people to get the care they need, when they need it. - Molly Joseph, CEO of UnitedHealthcare Global

Isapre Banmédica, part of UnitedHealthcare Global, has received MCG Health’s 2019 Richard L. Doyle Award.

Isapre Banmédica is one of the largest health plans in Chile, serving more than 850,000 members. Isapre Banmédica is being honored for advancements made in evidence-based clinical care management to improve the efficiency and quality of care for members. Over the course of six months, Isapre Banmédica’s clinical team conducted evidence-based reviews on more than 14,500 hospital admissions. Results during this time included:

  • reducing inappropriate admissions by 43%;
  • improving appropriateness of level of care for patients by 26 percentage points;
  • decreasing the difference between the actual length of stay and evidence-based expected length of stay from 1.92 days to 1.36 days

Isapre Banmédica worked with MCG’s Inpatient & Surgical Care, General Recovery Care, and Ambulatory Care guidelines to help achieve these results.

During this period, use of evidence-based guidelines enriched hospital provider communication, improved practice patterns, and established a baseline from which to compare hospital performance across the system.

“UnitedHealthcare Global keeps clinical quality at the center of everything we do in order to provide the best, most affordable health care to those we serve. Using evidence-based guidelines as a foundation, we focus on improving the quality of care for those we serve. That reduces unnecessary health care costs and allows more people to get the care they need, when they need it,” said Molly Joseph, CEO of UnitedHealthcare Global.

“It’s always reaffirming to see positive impacts from implementing evidence-based practices in health care,” said MCG President and CEO, Jon Shreve. “The results reported by Isapre Banmédica reflect the innovative decision-making of their leaders as well as their passion for improving the health outcomes and experiences of their members.”

This is the fourth time UnitedHealth Group has won the Richard L Doyle Award. In 2010, UnitedHealthcare won for successfully collaborating with hospital surgeons to safely reduce patient readmissions related to gastrointestinal (GI) surgery. Later, in 2016, UnitedHealthcare Global Solutions was recognized for improving quality of care delivery for people traveling and living abroad, and in 2017, UnitedHealthcare’s Amil won the award for improving health outcomes in Brazil. UnitedHealthcare Global is the only international organization to ever win this prestigious award and the only payer organization to win in two years in a row.

The Richard L. Doyle Award will be presented to Isapre Banmédica during MCG’s annual Client Forum in Orlando, Fla., May 17-20, 2020.

About UnitedHealthcare Global
UnitedHealthcare Global offers health plans, services and medical clinical care delivery in countries around the world, serving approximately 8 million unique members enrolled in medical and dental benefit plans. UnitedHealthcare Global operates in Brazil, through Amil, Americas Serviços Médicos and Optum; Chile, Colombia and Peru through Empresas Banmédica and its family of companies; and Portugal, through Lusíadas Saúde. UnitedHealthcare Global provides quality care to patients at 53 hospitals and more than 225 clinics and outpatient centers worldwide.

UnitedHealthcare Global also offers health and well-being solutions in more than 130 countries for employers and individuals who live, work or travel outside their home country. UnitedHealthcare Global is one of the businesses of UnitedHealth Group, a diversified health care company. For more information, visit UnitedHealthcare Global at https://www.uhcglobal.com/.

About Isapre Banmédica
Isapre Banmédica is a health care company with more than 30 years of experience. It serves more than 850,000 beneficiaries throughout Chile, offering a wide range of health plans and additional benefits and services all aimed at generating customized solutions for its customers’ needs.

About MCG Health
MCG, part of the Hearst Health network, helps healthcare organizations implement informed care strategies that proactively and efficiently move people toward health. MCG’s transparent assessment of the latest research and scholarly articles, along with our own data analysis, gives patients, providers, and payers the vetted information they need to feel confident in every care decision, in every moment. For more information visit https://www.mcg.com or follow our Twitter handle at @MCG_Health.

About Hearst Health
The mission of Hearst Health is to help guide the most important care moments by delivering vital information into the hands of everyone who touches a person’s health journey. Each year in the U.S., care guidance from Hearst Health reaches 85 percent of discharged patients, 205 million insured individuals, 99 million home health visits and 3.2 billion dispensed prescriptions. The Hearst Health network includes FDB (First Databank), Zynx Health, MCG, Homecare Homebase, MHK (formerly MedHOK—Medical House of Knowledge) and Hearst Health Ventures (http://www.hearsthealth.com). Hearst also holds a minority interest in the precision medicine and oncology analytics company M2Gen. Follow Hearst Health on Twitter @HearstHealth or LinkedIn @Hearst-Health.

About the Richard L. Doyle Award for Innovation and Leadership in Healthcare
The Doyle Award was developed to recognize organizations that make innovative use of the care guidelines to help deliver effective healthcare.

Dr. Doyle, the care guidelines founding editor, was a hospital chief-of-staff when he began creating clinical guidelines in the 1980s to help improve healthcare efficiency and quality at Mercy Hospital in San Diego. He later joined Milliman & Robertson and in 1988 published the first set of what was to become the care guidelines.

Judges for this award are independent healthcare quality experts, not currently associated with MCG. Applicants were judged on how well their projects supported the MCG mission to help drive effective care, and the names and locations of the nominees were redacted prior to the judges’ review. Judges looked for evidence of improvements in healthcare quality and patient safety; patient/member satisfaction; staff efficiency, productivity and satisfaction; internal/external communication; and effective use of resources.

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Arri Burgess
MCG Health
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