UnitedHealth Premium^® Designation Program

Not all health care is equal, and that can affect the care you receive. According to a study in The New England Journal of Medicine, "adults receive the recommended medical treatment only 55 percent of the time."¹ That's why UnitedHealthcare developed the UnitedHealth Premium® designation program, which recognizes physicians that meet guidelines for providing quality and cost efficient care.

No two doctors are alike, and you probably think about many factors when choosing a physician. We offer tools and information to help you make more confident health care decisions. When you're looking for a doctor, you can consider his or her Premium designation when making your choice. Physicians may also use these designations when referring patients to other physicians.

Physician designations are displayed publically on UnitedHealthcare’s physician directories found on www.myuhc.com®, www.oxfordhealth.com and other consumer websites. Physicians receive one of the following designations:

Premium Care Physician

The physician meets the criteria for providing quality and cost-efficient care.

Quality Care Physician

This physician meets the criteria for providing quality care but does not meet the criteria or is not evaluated for cost-efficient care.

Does Not Meet Quality

The physician does not meet the criteria for providing quality care so the physician is not eligible for the cost-efficient care designation.

Quality Not Evaluated

The program does not evaluate physicians in this specialty, there is not enough health plan claims data to evaluate, or evaluation is in process.

The fact that a physician has a Quality Not Evaluated or a Does Not Meet Quality designation does not mean that the physician does not provide quality health care services. All physicians in the UnitedHealthcare network have met certain minimum credentialing requirements (separate from the Premium program).

The designation of “Quality Not Evaluated” is given when a physician does not practice in a specialty that is evaluated by the Premium program. It is also given when a physician does not have enough health plan claims data to be evaluated, but it is not an indicator of the total number of patients treated by the physician or the number of procedures performed by the physician. Rather, it reflects the statistical requirements of the Premium program.

Employers may also choose to offer their employees a tiered benefit plan, which may offer an enhanced benefit in the form of lower member cost share for using Premium Care Physicians.

The Premium program evaluates more than 350,000 physicians across most states and specialties. For more information on the UnitedHealth Premium program, visit UnitedHealthPremium.com.

Access the documents below directly to view frequently asked questions about the program:

Use the links below to view the detailed methodology available to physicians, which includes information about the data, measures and statistical methods used to determine a physician's designation:

If you would like to provide feedback on the program, please send an email to PremiumProgram@uhc.com.

Important Notes about the Program

The UnitedHealth Premium® designation program is a resource for informational purposes only. Designations are displayed in UnitedHealthcare online physician directories at myuhc.com® and oxfordhealth.com. You should always visit myuhc.com or oxfordhealth.com for the most current information. Premium designations are a guide to choosing a physician and may be used as one of many factors you consider when choosing a physician. If you already have a physician, you may also wish to confer with him or her for advice on selecting other physicians. Physician evaluations have a risk of error and should not be the sole basis for selecting a physician. Please visit myuhc.com for detailed program information and methodologies.

¹Asch, Steven M. et al. The New England Journal of Medicine. 2006 March 16; 354: 1147-1156.

For a complete list of the specialties and medical conditions measured provided within the above FAQ document in all states: https://www.myuhc.com/content/myuhc/Member/Assets/Pdfs/Geoaccess/UnitedHealth_Premium_Specialty_Conditions.pdf

For a complete list of the specialties and medical conditions measured provided within the above FAQ document for Medica Service Area (Minnesota, North Dakota, South Dakota and portions of western Wisconsin): https://www.myuhc.com/content/myuhc/Member/Assets/Pdfs/Geoaccess/UnitedHealth_Premium_Specialty_Conditions_MN.pdf