The Whole Health Story: Health Plans Are Healthcare

UniCare talks with industry experts to pull the curtain back on health plans

July 29, 2022

A conversation with Dr. Bernard Bettencourt, UniCare's medical director.

Most people think a health plan is just the company that pays the medical bills. But there's a lot more to it than that. When members better understand their benefits, which are designed to support and encourage the best possible health outcomes, it results in better health overall.

While it’s true health insurers reimburse care providers on behalf of its members, our business is much more than that. We are focused on providing access to outcomes-driven healthcare, and we have people who are trained in clinical care and dedicated to providing tools, resources, and insights to improve our members’ health.

Part of our efforts includes ensuring members have access to the right care, in the right setting, at the right time.

When a company's focus is on bringing the right care to its members – and especially on ensuring access to the most effective care – it not only helps keep overall costs affordable, it also helps to ensure better health outcomes. The savings occur not because care was stopped. To the contrary, savings occur by ensuring the right care in the right setting. This also leads to a better overall experience for the healthcare consumer.

What does "the right care" mean? It means members going to their primary care provider for minor ailments or routine care instead of to the emergency room. It means addressing health concerns before they develop into serious or chronic conditions. It means getting medications filled, and taking them as prescribed, to reduce the likelihood of a condition getting worse or ending up in the hospital. It means receiving services at lower cost options, such as independent labs, ambulatory surgical centers, or urgent care centers, as appropriate, rather than at a hospital, which can dramatically increase costs for consumers. These actions not only cost less but can be more convenient and help members avoid unnecessary hospital stays.

Health plans today are healthcare companies. We partner with our members to advance the best possible health outcomes and keep costs affordable.

This article is part of a blog series from UniCare, "The Whole Health Story," where we talk with various members of our team and leading health industry experts to dive into the inner workings of health plans, explain what whole health means, and much more.