Quality highlights
Quality matters at UCare
UCare is a health plan in Minnesota and western Wisconsin. UCare serves:
- Individuals and families choosing insurance through MNsure and the insurance marketplace in 77 counties
- Medicare-eligible individuals in all 87 counties
- Individuals and families enrolled in Minnesota health care programs, such as MinnesotaCare and Medical Assistance in 45 counties
- Adults with disabilities in 67 counties
Our Quality programs continue to see positive outcomes as we support and improve our members' health.
Our programs
2024 Star Ratings
Every year, the Centers for Medicare & Medicaid Services (CMS) measures and awards plans based on a 5-star rating system. These Star Ratings may change from one year to the next based on how a health plan serves you and supports your health.
Current Star Ratings:
- UCare Medicare – 4.5 out of 5 stars
- UCare's Minnesota Senior Health Options – 4 out of 5 stars
- UCare Connect + Medicare – 3.5 out of 5 stars
- EssentiaCare – 4.5 out of 5 stars
- UCare Individual & Family Plans – 4 out of 5 stars
- UCare Medicare with M Health Fairview & North Memorial – 3.5 out of 5 stars
Why do Star Ratings matter?
You can use these Star Ratings to compare our plan’s performance to other plans and find the one that best meets your needs. You can look up Medicare plans and review their ratings at medicare.gov. For Individual & Family Plans, visit mnsure.org.
How can you help?
- Get your annual wellness exam every year
- Get the preventive care and screenings your doctor recommends
- Talk about your physical and mental health with your doctor
- Complete and return all member surveys
- Work with your doctor or pharmacy to stay up-to-date on your prescription drugs
How can I enroll in a high-performing 4.5-star plan like UCare Medicare?
To learn more, schedule a call with a licensed Medicare sales specialist by calling 612-676-3500 (TTY users call 612-676-6810 or 1-800-688-2534).
Hours of operation:
8 am – 8 pm, seven days a week (Oct. 1 – March 31)
8 am – 8 pm, Monday – Friday (April 1 – Sept. 30)
NCQA Accreditation
NCQA is a private, non-profit organization dedicated to improving health care quality. NCQA’s website contains information to help consumers and others make more informed health care choices.
Health Plan Accreditation
UCare’s full line of Medicare, Medicaid and Individual & Family health plans maintain Health Plan Accreditation from the National Committee for Quality Assurance (NCQA). This accreditation shows that UCare is committed to the highest standards of quality.
Health Equity Accreditation
As of January 2023, UCare’s Medicaid plans achieved Health Equity Accreditation from NCQA. This accreditation recognizes UCare as a market leader providing services sensitive to members’ cultural and language preferences in addition to working to reduce health inequities and improve care.
Learn more about our Quality programs
Every year, UCare reviews the work from last year and sets new goals for this year.
Quality Management Program Description 2023
Quality Management Program Evaluation Executive Summary 2022
Quality Management Program Work Plan 2023
Member satisfaction
Member feedback is important to UCare — we want to hear from you. The Centers for Medicare & Medicaid Services (CMS) and Department of Human Services (DHS) measures UCare’s overall performance as a health plan through yearly member experience surveys. The surveys help health plans identify opportunities to improve quality and services and help CMS and DHS monitor the performance of these plans.
We hope you are satisfied with your plan and willing to share your experience with us. If for any reason you are unhappy with our service, let us know by calling the customer service number on the back of your member ID card or send a secure message through your online member account.
UCare scored above the national average on several 2022 member satisfaction measures. UCare identified the following focus areas and improvement opportunities for 2023:
| Focus area | Improvement opportunities |
| Customer service |
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| Rating of health plan |
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| Rating of drug plan |
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UCare's Quality Improvement initiatives
UCare wants to continually improve our products and operations to provide you with the highest quality of care. UCare looks at performance data and member experience feedback to identify where we can make improvements. We ask members and community partners to help us develop programs and activities that improve health, lower costs and reduce health gaps. Improvement activities are assessed to make sure they are helping us achieve our goals. We've highlighted a few key activities as part of our mission.
Making it easier for you to see a dentist
This project promotes oral health and the importance of yearly dental visits for children and families.
For UCare members with: UCare Connect (SNBC), UCare Connect + Medicare (HMO D-SNP), MinnesotaCare, Minnesota Senior Care Plus (MSC+), UCare’s Minnesota Senior Health Options (MSHO) (HMO D-SNP)
Goal: To increase the number of members that visit a dentist every year
| For members | What we do | For providers |
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If you need assistance finding or locating a dental provider, please call UCare Dental Connection at 651-768-1415 (TTY users call 711) or 1-855-648-1415 (toll free), from 7 am – 7 pm, Monday – Friday or contact customer service.
The dental table shows results from 2019 – 2021 trended data.
| Annual Dental Visit Rate | 2019 | 2020 | 2021 |
| MinnesotaCare | 34.42% | 24.45% | 27.81% |
| PMAP | 41.69% | 30.87% | 35.50% |
| Connect/Connect + Medicare | 46.77% | 36.82% | 34.58% |
| MSHO/MSC+ | 36.81% | 24.20% | 32.17% |
Current performance improvement projects (PIP):
UCare works with other Minnesota health plans and the Department of Human Services (DHS) to improve the health of Minnesotans.
Healthy Start for Mothers and their Children
This project promotes a “Healthy Start” for Minnesota mothers and their children, particularly those with the most significant racial and ethnic gaps.
For UCare members with: Prepaid Medical Assistance Program (PMAP), MinnesotaCare
Goal: To provide timely prenatal and postpartum care to our members, increase well-child visits, encourage childhood vaccines and decrease health gaps
| for members | what we do | for providers |
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In the tables for maternal health, UCare has calculated the project baseline rates (2019) and trending data for each of the measures and drill-down analysis on health care gaps.
Maternal health measures:
| HEDIS 2019 | HEDIS MY2020 | HEDIS MY2021 | |
| Overall rates | |||
| Family and children | 50.96% | 73.02% | 54.57% |
| Race | |||
| Black, Indigenous and people of color | 53.38% | 78.13% | 57.84% |
| White/Caucasian | 46.01% | 67.67% | 51.35% |
| Geographic location | |||
| Metro | 55.72% | 77.25% | 59.82% |
| Rural | 36.96% | 61.80% | 41.29% |
| HEDIS 2019 | HEDIS MY2020 | HEDIS MY2021 | |
| Overall rates | |||
| Family and children | 39.00% | 46.35% | 54.76% |
| Race | |||
| Black, Indigenous and people of color | 29.46% | 43.40% | 49.05% |
| White/Caucasian | 41.98% | 51.00% | 57.01% |
| Geographic location | |||
| Metro | 38.02% | 47.97% | 51.56% |
| Rural | 41.73% | 51.27% | 56.98% |
Childhood measures:
| HEDIS 2019 | HEDIS MY2020 | HEDIS MY2021 | |
| Overall rates | |||
| Family and children | 51.66% | 36.34% | 47.26% |
| Race | |||
| Black, Indigenous and people of color | 43.79% | 30.02% | 41.94% |
| White/Caucasian | 53.37% | 29.31% | 53.19% |
| Geographic location | |||
| Metro | 51.73% | 37.12% | 47.19% |
| Rural | 51.46% | 33.56% | 45.86% |
| HEDIS 2019* | HEDIS MY2020* | HEDIS MY2021 | |
| Overall rates | |||
| Family and children | -- | -- | 59.63% |
| Race | |||
| Black, Indigenous and people of color | -- | -- | 56.85% |
| White/Caucasian | -- | -- | 65.10% |
| Geographic location | |||
| Metro | -- | -- | 59.66% |
| Rural | -- | -- | 59.59% |
*The W30 measure was added to HEDIS in MY2021 and will be reported for the remainder of the project but does not allow for baseline (MY2019) comparison.
| HEDIS 2019 | HEDIS MY2020 | HEDIS MY2021 | |
| Overall rates | |||
| Family and children | 39.00% | 37.94% | 34.80% |
| Race | |||
| Black, Indigenous and people of color | 29.46% | 27.36% | 26.00% |
| White/Caucasian | 41.98% | 41.98% | 45.50% |
| Geographic location | |||
| Metro | 38.02% | 34.37% | 33.93% |
| Rural | 41.73% | 38.51% | 36.90% |
Improving diabetes care
This project is to improve diabetes care and services with a focus on members with health care gaps. Race or ethnicity, sex, sexual identity, age, disability, socioeconomic status and geographic location all contribute to a person’s ability to achieve good health.
For UCare members with: UCare Connect (SNBC), UCare Connect + Medicare (HMO D-SNP), Minnesota Senior Care Plus (MSC+), UCare’s Minnesota Senior Health Options (MSHO) (HMO D-SNP)
Goal: To improve diabetes care for members
| For members | What we do | For providers |
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| HEDIS 2019 | HEDIS MY2020 | HEDIS MY2021 | |
| Overall HEDIS rates | |||
| Connect | 91.3% | 89.3% | 92.7% |
| Connect + Medicare | 95.6% | 92.5% | 94.9% |
| MSC+ | 88.3% | 78.8% | 85.7% |
| MSHO | 96.4% | 88.1% | 94.6% |
| Race | |||
| Native American | 76.7% | ** | ** |
| Asian or Pacific Islander | 91.5% | 81.3% | 89.8% |
| Black or African American | 92.6% | 83.7% | 88.3% |
| People of color | 91.7% | 82.9% | 88.8% |
| White/Caucasian | 91.6% | 86.7% | 90.6% |
| Geographic location | |||
| Metropolitan | 91.7% | 84.5% | 89.3% |
| Micropolitan | 87.6% | 86.2% | 93.0% |
| Rural | 94.2% | 83.9% | 83.9% |
| HEDIS 2019 | HEDIS MY2020 | HEDIS MY2021 | |
| Overall HEDIS rates | |||
| Connect | 64.5% | 68.1% | 70.1% |
| Connect + Medicare | 71.8% | 71.8% | 771% |
| MSC+ | ** | ** | ** |
| MSHO | 66.4% | 59.4% | 70.7% |
| Race | |||
| Native American | 63.3% | ** | ** |
| Asian or Pacific Islander | 65.9% | 54.5% | 64.8% |
| Black or African American | 59.2% | 53.3% | 64.4% |
| People of color | 61.9% | 53.6% | 64.6% |
| White/Caucasian | 72.2% | 74.3% | 78.2% |
| Geographic location | |||
| Metropolitan | 67.9% | 65.0% | 71.2% |
| Micropolitan | 61.6% | 76.7% | 81.1% |
| Rural | 65.8% | 72.6% | 74.2% |
| HEDIS 2019 | HEDIS MY2020 | HEDIS MY2021 | |
| Overall HEDIS rates | |||
| Connect | 70.1% | 62.5% | 60.1% |
| Connect + Medicare | 76.6% | 69.1% | 72.0% |
| MSC+ | 63.8% | 57.6% | 58.5% |
| MSHO | 79.6% | 76.4% | 74.4% |
| Race | |||
| Native American | 70.0% | ** | ** |
| Asian or Pacific Islander | 63.9% | 57.5% | 55.1% |
| Black or African American | 72.8% | 61.7% | 62.0% |
| People of color | 69.2% | 60.3% | 59.4% |
| White/Caucasian | 71.7% | 67.2% | 66.8% |
| Geographic location | |||
| Metropolitan | 70.3% | 63.7% | 62.9% |
| Micropolitan | 70.1% | 69.3% | 62.9% |
| Rural | 72.5% | 57.0% | 58.0% |
| HEDIS 2019 | HEDIS MY2020 | HEDIS MY2021 | |
| Overall HEDIS rates | |||
| Connect | 87.2% | ** | ** |
| Connect + Medicare | 91.2% | 89.5% | 92.7% |
| MSC+ | 83.9% | ** | ** |
| MSHO | 93.7% | 93.2% | 94.6% |
| Race | |||
| Native American | 66.7% | ** | ** |
| Asian or Pacific Islander | 88.9% | 89.6% | 95.2% |
| Black or African American | 89.2% | 88.5% | 91.8% |
| People of color | 88.5% | 88.8% | 93.2% |
| White/Caucasian | 86.6% | 92.8% | 93.5% |
| Geographic location | |||
| Metropolitan | 87.5% | 90.8% | 93.5% |
| Micropolitan | 89.1% | 94.7% | 96.2% |
| Rural | 87.0% | 96.9% | ** |
**For MY's 2020 and 2021, NCQA did not require the nephropathy measure for Medicaid products, so Connect only includes one year (2019) of data in this submeasure. For geographical location, results with denominators less than 30 or numerators less than 10 were suppressed due to rate instability from small numbers.
Past performance improvement project:
Reducing chronic opioid use
This project addressed the ongoing opioid epidemic and preventing UCare members from opioid addiction through provider and member education.
For members with: Prepaid Medical Assistance Program (PMAP), MinnesotaCare, UCare Connect, UCare Connect (SNBC), UCare Connect + Medicare (HMO D-SNP), Minnesota Senior Care Plus (MSC+), UCare’s Minnesota Senior Health Options (MSHO) (HMO D-SNP)
Goal: To reduce the number members that are new chronic users (NCU) of opioid pain relievers. An NCU is defined as a person who hasn't used opioids in the past who's prescribed an opioid for a 45-day or more supply over a consecutive 90-day period
In the tables for new chronic users, Minnesota DHS provided 2016 baseline rates and UCare was responsible for calculating our own metrics beyond the baseline year. UCare has met its overall goal to reduce the NCU rate. In both the internally calculated rates and the baseline data DHS provided, UCare saw a decrease in NCU rates from 2018 – 2019 across all product lines. For members in the PMAP and MinnesotaCare programs, trends showed encouraging declines in the NCU rate compared to the 2016 baseline year.
| 2016 (Baseline)* | 2017 | 2018 | 2019 | |
| Connect | 9.48% | 9.71% | 9.76% | 6.90% |
| Connect + Medicare | -- | 34.88% | 24.43% | 16.30% |
| EssentiaCare |
22.92% | 10.47% | 6.84% | 15.80% |
| Medicare Advantage | 8.73% | 8.37% | 7.95% | 11.10% |
| MinnesotaCare | 3.39% | 5.95% | 2.95% | 2.50% |
| MSC+ | 7.69% | 7.37% | 9.66% | 4.80% |
| MSHO | 16.15% | 17.83% | 17.23% | 13.60% |
| PMAP | 3.22% | 3.44% | 4.11% | 2.90% |
*DHS provided MCOs with 2016 baseline data.
| UCare interventions |
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To see more of UCare's work on important current and past projects, visit Stratis Health's Collaborative Health Plan performance improvement projects webpage.
Stratis Health is a non-profit organization that aims to collaborate and improve health by guiding health improvement initiatives. Stratis Health facilitates and works with Managed Care Organizations (MCOs) such as UCare.